Neuropathic pain of peripheral origin

  title={Neuropathic pain of peripheral origin},
  author={Bradley S Galer},
  pages={S17 - S25}
  • B. Galer
  • Published 1 December 1995
  • Medicine, Psychology
  • Neurology
A variety of mechanisms may generate pain resulting from injury to the peripheral nervous system.None of these mechanisms is disease-specific, and several different pain mechanisms may be simultaneously present in any one patient, independent of diagnosis. Diagnosis of neuropathic pain is often easily made from information gathered on neurologic examination and from patient history. Evidence of sensory disturbances elicited on examination combined with laboratory tests confirming injury to… 

Tables from this paper

Treatment of painful peripheral neuropathy.
Neuropathic pain management remains challenging because of heterogeneous responses between individuals and the fact that pain relief is rarely complete, however, monotherapy with a well-chosen agent or rational polypharmacy that combines medications with different mechanisms of action will benefit a majority of patients with neuropathic pain.
Treatment of Painful Peripheral Neuropathy
Treatment of Neuropathic Pain
Pharmacotherapy is the mainstay of neuropathic pain management, with the majority of clinical data supporting the use of three main drug classes: tricyclic antidepressants; (1) anticonvulsants; and (3) anesthetic-antiarrhythmics.
Neuropathic pain: etiology, pathophysiology, mechanisms, and evaluations.
Spinal pain syndromes: nociceptive, neuropathic, and psychologic mechanisms.
Treatment considerations in neuropathic pain
  • R. J. Leo
  • Medicine, Psychology
    Current treatment options in neurology
  • 2006
Treatment of depression may be essential to fully enlist the chronic neuropathic pain patient in comprehensive pain management and rehabilitative approaches.
Medical and pharmacologic management of upper extremity neuropathic pain syndromes.
  • G. Mackin
  • Medicine, Psychology
    Journal of hand therapy : official journal of the American Society of Hand Therapists
  • 1997
Topical medications for orofacial neuropathic pain: a review.
Topical medications offer a distinct advantage over systemic administration for those orofacial disorders that are regional, near the surface and chronic and that demonstrate some response such as pain relief to topical or subcutaneous anesthetics.
Neuropathic cranial pain
The introduction in the therapeutical armamentarium of antiepileptic drugs and the results derived from clinical studies indicate that some of these compounds show promise in the treatment of neuropathic pain.


The use of oral mexiletine for the treatment of pain after peripheral nerve injury.
Mexiletine may be effective in reducing neuropathic pain for patients in whom alternative pain medications have been unsatisfactory, and is found to produce a statistically significant reduction in reported pain when compared to baseline or placebo.
Prevalence and forms of neuropathic morbidity in 800 diabetics
Overall; 22.9% of the population was afflicted by one or more problems resulting from neuropathy, associated with older age, and serious retinopathy in both groups of diabetics and with duration of diabetes.
Analgesic concentrations of lidocaine suppress tonic A-delta and C fiber discharges produced by acute injury.
Results show that analgesia produced by lidocaine appears to result from suppression of tonic neural discharge in injured peripheral A-delta and C fiber nociceptors, and the median effective concentration (ED50) corresponds to clinically effective plasma concentrations for analgesia.
Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy.
Desipramine relieves pain caused by diabetic neuropathy with efficacy similar to that of amitriptyline, offering an alternative for patients unable to tolerate the latter and blockade of norepinephrine reuptake is likely to mediate the analgesic effect of these antidepressant drugs in diabetic Neuropathy.