Birklein F
Neurologische Universitätsklinik Mainz, Germany.
Fortschr Neurol Psychiatr. 2002 Feb;70(2):88-94. doi: 10.1055/s-2002-19922.
Traditionally, neuropathic pain has been classified due to aetiology of nerve damage-traumatic, inflammatory or metabolic, for instance. Based on this classification, pain therapy often is insufficient. Recent research revealed different mechanisms, which are responsible for the generation of pain after nerve lesion. These mechanisms seem to be independent of aetiology of the nerve damage. The most important mechanisms are accumulation of sodium channels on injured nerves, pathological sympatho-afferent coupling, disinhibition of nociception and central or peripheral nociceptive sensitisation. Each individual mechanism could be treated specifically by current available drugs, or by non-drug therapy. However, future research has to focus on exploring tools to recognise individual pain mechanisms in single patients. Thereby treatment will become more effective.
传统上，神经性疼痛是根据神经损伤的病因进行分类的，例如创伤性、炎症性或代谢性。基于这种分类，疼痛治疗往往并不充分。最近的研究揭示了不同的机制，这些机制导致神经损伤后疼痛的产生。这些机制似乎与神经损伤的病因无关。最重要的机制是损伤神经上钠通道的积累、病理性交感神经传入耦合、伤害感受的去抑制以及中枢或外周伤害性致敏。目前可用的药物或非药物疗法可以分别针对每种机制进行治疗。然而，未来的研究必须集中于探索识别单个患者个体疼痛机制的工具。由此，治疗将变得更加有效。
