Pharmacological Treatment of Neuropathic Pain Joost Jongen Brussels, June 13th, 2015
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Pharmacological Treatment of
Neuropathic Pain
Joost Jongen
Brussels, June 13th, 2015
Introduction
• A diagnosis of neuropathic pain
• Pharmacological treatment of neuropathic
pain
• Neuropathic pain in cancer patients
A diagnosis of neuropathic pain-Hypothesis I
One should NOT treat neuropathic pain,
that is NOT neuropathic pain
A diagnosis of neuropathic pain
DRG
Motor
innervation
Sensory
innervation
A diagnosis of neuropathic pain
-Ataxia
-Loss of Touch
-Loss of Dexterity
Large
diamete
r
Small diameter
-Muscle Atrophy
-Loss of
Strength
Large
diameter
sensory nerve
fibers
-Autonomic dysfunction
-Loss of thermo-perception
-Neuropathic Pain
Motor nerve
fibers
Small diameter
sensory nerve
fibers
A diagnosis of neuropathic pain
Manuscript in preparation
A diagnosis of neuropathic pain
Manuscript in preparation
A diagnosis of neuropathic pain
Treede et al. Neurology 2008; 70: 1630-1635
Pharmacological treatment of neuropathic pain-Hypothesis II
One should NOT treat mild neuropathic
pain
Pharmacological treatment of neuropathic pain
Lancet Neurol. 2015; 14: 162-173
Pain Practice 2014; 14(3): 183-295
Pharmacological treatment of neuropathic pain
Pain Practice 2014; 14(3): 183-
295
Pain 2014; 155: 2263-
2273
Pharmacological treatment of neuropathic pain-Hypothesis III
Pharmacological treatment of
neuropathic pain should be based on
clinical evidence and rational
pharmacotherapy
Pharmacological treatment of neuropathic pain
Groeneveld & Jongen. Tijdschr. Neurol. Neurochir. 2013; 114:
119-129
Pharmacological treatment of neuropathic pain
Groeneveld & Jongen. Tijdschr. Neurol. Neurochir. 2013; 114:
119-129
Pharmacological treatment of neuropathic pain
Pain Practice 2014; 14(3): 183-295
Neuropathic pain in cancer patients-Hypothesis IV
Neuropathic pain in cancer patients is a
special entity, that encompasses both
mixed and purely neuropathic pain
Neuropathic pain in cancer patients
• Nociceptive pain (due to cancer)
• Mixed nociceptive-neuropathic pain (due to
cancer)
• Purely neuropathic cancer pain (due to
cancer treatment)
Neuropathic pain in cancer patients-Nociceptive pain (?)
Soc. Neurosci. Abstr. 2002
Neuropathic pain in cancer patients-Mixed pain
Neuropathic pain in cancer patients-Purely neuropathic pain
J. Neurooncol. 2015; 121: 229-237
Pharmacological treatment of neuropathic pain in cancer patients
J Pain Symptom Manage. 2013; 46: 581-590
Conclusions
• One should not treat neuropathic pain, that is
not neuropathic pain
• One should not treat mild neuropathic pain
• Pharmacological treatment of neuropathic
pain should be based on clinical evidence
and rational pharmacotherapy
• Neuropathic pain in cancer patients is a
special entity, that encompasses both mixed
and purely neuropathic pain
Related Documents
