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通过问卷诊断和评估神经性疼痛。

Diagnosis and assessment of neuropathic pain through questionnaires.

机构信息

INSERM-U987, CHU Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France; Université de Versailles Saint Quentin en Yvelines, Versailles, France.

INSERM-U987, CHU Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France; Université de Versailles Saint Quentin en Yvelines, Versailles, France.

出版信息

Lancet Neurol. 2018 May;17(5):456-466. doi: 10.1016/S1474-4422(18)30071-1. Epub 2018 Mar 26.

Abstract

Neuropathic pain-pain caused by a lesion or disease of the somatosensory nervous system-is underdiagnosed and difficult to treat. However, development of easy-to-use questionnaires based mainly on self-reports of symptoms has improved diagnosis and management. Two types of questionnaires (screening and assessment) have been validated, and rapidly translated and revalidated in several languages, probably because of their simplicity. Screening questionnaires help clinicians to identify neuropathic pain easily, particularly in patients with complex medical conditions (eg, spinal cord injury). Their use in large-scale epidemiological studies has provided estimates of the prevalence of neuropathic pain and identified risk factors for neuropathic pain in the general population and in disorders such as diabetes. Assessment questionnaires measure neuropathic symptoms and have been used to create phenotypic profiles of patients in various neuropathic conditions. These profiles can predict treatment outcomes, and thus enable a personalised therapeutic approach. The dissemination of these questionnaires in different countries should further improve diagnosis and management worldwide and advance knowledge on the mechanisms of neuropathic pain.

摘要

神经病理性疼痛——由躯体感觉神经系统的损伤或疾病引起的疼痛——诊断不足且难以治疗。然而,基于症状自我报告的易于使用的问卷的开发已经改善了诊断和管理。两种类型的问卷(筛查和评估)已经过验证,并已在多种语言中快速翻译和重新验证,这可能是因为它们很简单。筛查问卷有助于临床医生轻松识别神经病理性疼痛,特别是在患有复杂医疗状况(例如脊髓损伤)的患者中。它们在大规模的流行病学研究中的使用提供了神经病理性疼痛的患病率估计,并确定了一般人群和糖尿病等疾病中神经病理性疼痛的风险因素。评估问卷测量神经病理性症状,并已用于为各种神经病理性疾病的患者创建表型谱。这些表型谱可以预测治疗结果,从而实现个性化的治疗方法。这些问卷在不同国家的传播应进一步改善全球的诊断和管理,并增进对神经病理性疼痛机制的认识。

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