Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations |
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Authors: | Dworkin Robert H Backonja Miroslav Rowbotham Michael C Allen Robert R Argoff Charles R Bennett Gary J Bushnell M Catherine Farrar John T Galer Bradley S Haythornthwaite Jennifer A Hewitt David J Loeser John D Max Mitchell B Saltarelli Mario Schmader Kenneth E Stein Christoph Thompson David Turk Dennis C Wallace Mark S Watkins Linda R Weinstein Sharon M |
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Affiliation: | Department of Anesthesiology, University of Rochester School of Meedicine and Dentistry, Rochester, NY 14642. robert_dworkin@urmc.rochester.edu |
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Abstract: | Chronic neuropathic pain, caused by lesions in the peripheral or central nervous system, comes in many forms. We describe current approaches to the diagnosis and assessment of neuropathic pain and discuss the results of recent research on its pathophysiologic mechanisms. Randomized controlled clinical trials of gabapentin, the 5% lidocaine patch, opioid analgesics, tramadol hydrochloride, and tricyclic antidepressants provide an evidence-based approach to the treatment of neuropathic pain, and specific recommendations are presented for use of these medications. Continued progress in basic and clinical research on the pathophysiologic mechanisms of neuropathic pain may make it possible to predict effective treatments for individual patients by application of a pain mechanism-based approach. |
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