What's New in Neuropathy?
| Autor: | Varrassi G; Department of Pain Medicine, Paolo Procacci Foundation, Rome, ITA., Tamburin S; Department of Neurology, University of Verona, Verona, ITA., Zis P; Department of Neurology, University of Cyprus, Nicosia, CYP., Guardamagna VA; Department of Anesthesia, European Institute of Oncology (IEO), Milano, ITA., Paladini A; Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, ITA., Rekatsina M; Department of Anesthesiology and Pain Management, University of Athens, Athens, GRC. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 Sep 09; Vol. 15 (9), pp. e44952. Date of Electronic Publication: 2023 Sep 09 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.44952 |
| Abstrakt: | Neuropathic pain presents diagnostic and treatment challenges. Despite recent advances in our understanding of the diagnosis and treatment of neuropathy, much remains to be elucidated. Familiar with neuropathy is the paradox that aberrant nerve signaling causes both sensory loss and pain. Voltage-gated sodium channels play an important role in neuronal electrogenesis and communication among neurons, and their dysregulation leads to hyperexcitability and pain. While numerous validated diagnostic assessment tools are available for neuropathy, patients often experience a diagnostic delay about the cause of their neuropathy. New research is defining more specific types of neuropathy beyond peripheral and central forms. The prevalence of pain varies by type of neuropathy, with chronic idiopathic axonal polyneuropathy associated with the highest proportion of patients experiencing pain. In the majority of types, it exceeds 50%. Gluten neuropathy, a form of peripheral neuropathy, is a new diagnostic consideration. It may require electrochemical conductance testing of hands and feet to test for sudomotor dysfunction. Among those with serologically confirmed gluten sensitivity or celiac disease, gluten neuropathy is a common neurological manifestation and may be addressed at least partially by a gluten-free diet. In Greece, a new neuropathic pain registry was created in 2014 in order to help gather data from real-world neuropathic pain patients. While still in its earliest phase, this registry has already produced demographic and treatment data that suggest suboptimal prescribing and less than recommended use of interventional procedures. Awareness campaigns are underway to encourage more Greek pain clinics to participate in this important registry. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Varrassi et al.) |
| Databáze: | MEDLINE |
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