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- Defined as pain caused by direct nerve injury
- An injury to either the peripheral or central nervous system (CNS) can lead to neuropathic pain.
- Can exist without ongoing disease
- Can arise from damage to nerve pathways at any point from terminals of the peripheral nociceptors to cortical neurons in the brain
- Causes include traumatic nerve injury, infection, metabolic injury, autoimmune disease, neoplasm, drugs, radiation, and neurovascular disorders.
Includes chronic conditions that affect up to 10% of the population (1)
Etiology and Pathophysiology
- Positive symptoms due to changes in peripheral nerves, loss of inhibitory mechanisms in CNS, and central sensitization
- Negative symptoms (sensory deficits) reflect neural damage.
- Associated with numerous conditions, including:
- Demyelinating disorders (multiple sclerosis, Guillain-Barré syndrome)
- Neoplasm (primary/metastatic)
- Neurovascular (central poststroke syndrome, diabetes, trigeminal neuralgia)
- Autoimmune disease (Sjögren syndrome, polyarteritis nodosa)
- Structural disease (herniated disc disease) (2)
- General risk factors include older age, female gender, physical inactivity, and manual occupation.
- There is growing evidence of genetic factors.
- Includes conditions that cause nerve damage or potentiate symptoms from damaged nerves:
- Herpes zoster
- Trigeminal neuralgia
- Lyme disease
- Cancer and chemotherapy
- Multiple sclerosis
- Limb amputation
- Nutritional deficiencies
Commonly Associated Conditions
- Substance abuse