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神经系统疾病中的神经性疼痛:一篇叙述性综述。

Neuropathic Pain in Neurologic Disorders: A Narrative Review.

作者信息

Mitsikostas Dimos-Dimitrios, Moka Eleni, Orrillo Enrique, Aurilio Caterina, Vadalouca Athina, Paladini Antonella, Varrassi Giustino

机构信息

First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, GRC.

Department of Anesthesiology, Creta Interclinic Hospital, Herakleion, GRC.

出版信息

Cureus. 2022 Feb 20;14(2):e22419. doi: 10.7759/cureus.22419. eCollection 2022 Feb.

Abstract

Neuropathic pain is defined as a painful condition caused by neurological lesions or diseases. Sometimes, neurological disorders may also be associated with neuropathic pain, which can be challenging to manage. For example, multiple sclerosis (MS) may cause chronic centralized painful symptoms due to nerve damage. Other chronic neuropathic pain syndromes may occur in the form of post-stroke pain, spinal cord injury pain, and other central pain syndromes. Chronic neuropathic pain is associated with dysfunction, disability, depression, disturbed sleep, and reduced quality of life. Early diagnosis may help improve outcomes, and pain control can be an important factor in restoring function. There are more than 100 different types of peripheral neuropathy and those involving sensory neurons can provoke painful symptoms. Accurate diagnosis of peripheral neuropathy is essential for pain control. Further examples are represented by gluten neuropathy, which is an extraintestinal manifestation of gluten sensitivity and presents as a form of peripheral neuropathy; in these unusual cases, neuropathy may be managed with diet. Neuropathic pain has been linked to CoronaVirus Disease (COVID) infection both during acute infection and as a post-viral syndrome known as long COVID. In this last case, neuropathic pain relates to the host's response to the virus. However, neuropathic pain may occur after any critical illness and has been observed as part of a syndrome following intensive care unit hospitalization.

摘要

神经病理性疼痛被定义为由神经病变或疾病引起的疼痛状况。有时,神经疾病也可能与神经病理性疼痛相关,而这种疼痛可能难以处理。例如,多发性硬化症(MS)可能由于神经损伤而导致慢性中枢性疼痛症状。其他慢性神经病理性疼痛综合征可能以中风后疼痛、脊髓损伤疼痛及其他中枢性疼痛综合征的形式出现。慢性神经病理性疼痛与功能障碍、残疾、抑郁、睡眠障碍及生活质量下降有关。早期诊断可能有助于改善预后,而疼痛控制可能是恢复功能的一个重要因素。有100多种不同类型的周围神经病变,其中涉及感觉神经元的病变可引发疼痛症状。准确诊断周围神经病变对于控制疼痛至关重要。进一步的例子有麸质神经病,它是麸质敏感性的一种肠外表现,表现为周围神经病变的一种形式;在这些特殊情况下,神经病可用饮食疗法治疗。神经病理性疼痛在急性感染期间以及作为一种称为“长新冠”的病毒后综合征都与冠状病毒病(COVID)感染有关。在后一种情况下,神经病理性疼痛与宿主对病毒的反应有关。然而,神经病理性疼痛可能在任何危重病后发生,并且已被观察到是重症监护病房住院后综合征的一部分。

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