scholarly journals Agreement Between the Douleur Neuropathique in 4 Questions and Leeds Assessment of Neuropathic Symptoms and Signs Questionnaires to Classify Neuropathic Pain Among Patients with Leprosy

2016 ◽  
Vol 95 (4) ◽  
pp. 756-759 ◽  
Author(s):  
Jamilly C. V. Santana ◽  
Francisco P. Reis ◽  
Vera L. C. Feitosa ◽  
Julianne C. V. Santana ◽  
Luis E. Cuevas ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Douleur Neuropathique ◽  
Symptoms And Signs

Dor neuropática – investigação e tratamento específico

2021 ◽  
pp. 17-27
Author(s):  
Gabriel Taricani Kubota ◽  
Daniel Ciampi Araújo de Andrade
Keyword(s):  
Neuropathic Pain ◽  
Interest Group ◽  
Special Interest ◽  
Special Interest Group ◽  
Douleur Neuropathique ◽  
Impacto Económico

A dor neuropática é uma condição clinicamente definida e provocada por uma lesão ou doença de vias neurológicas somatossensitivas. Ela ocorre em aproximadamente 7% a 10% da população mundial, e resulta em grande impacto econômico e sobre a qualidade de vida dos doentes. Os seus critérios diagnósticos levam em consideração: a história compatível com dor neuropática por uma lesão e/ou doença relevante; distribuição neuroanatomicamente plausível da dor, e testes diagnósticos que confirmem a presença da lesão e/ou doença em questão. Instrumentos de rastreio, como o Douleur Neuropathique en 4 Questions (DN-4) podem auxiliar em sua identificação, especialmente por não especialistas. Cuidados multidisciplinares são parte importante do tratamento destes doentes, porém a farmacoterapia é ainda hoje o seu elemento fundamental. As diretrizes da NeuPSIG (Neuropathic Pain – Special Interest Group) recomendam ligantes da subunidade α2δ de canais de cálcio sensíveis a voltagem (gabapentina e pregabalina), inibidores de recaptação de serotonina e noradrenalina (duloxetina e venlataxina) e antidepressivos tricíclicos como primeira linha terapêutica; emplastros de lidocaína 5% e de capsaicina 8%, e tramadol como segunda linha; e onabotulinumtoxina A e opioides fortes (morfina e oxicodona) como terceira linha. A escolha da melhor estratégia terapêutica, no entanto, deve ser individualizada e levar em consideração o tipo de dor neuropática (periférica vs. central), extensão da área acometida, comorbidades e preferências do paciente, riscos de interações farmacológicas e de efeitos colaterais. Casos refratários devem ser conduzidos preferencialmente por médico especialista em dor, e para eles modalidades terapêuticas invasivas e neuromodulação podem ser considerados. Unitermos: Dor crônica. Dor neuropática. Analgesia, diagnóstico, tratamento.

scholarly journals Identifying Neuropathic Pain in Patients with Head and Neck Cancer: Use of the Leeds Assessment of Neuropathic Symptoms and Signs Scale

2003 ◽  
Vol 96 (8) ◽  
pp. 379-383 ◽  
Author(s):  
Jean Potter ◽  
Irene J Higginson ◽  
John W Scadding ◽  
Columba Quigley
Keyword(s):  
Neuropathic Pain ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Care Physician ◽  
Pain Specialist ◽  
Bedside Test ◽  
Symptoms And Signs

The Leeds Assessment of Neuropathic Symptoms and Signs Scale (LANSS) is a simple bedside test in two parts—a patient-completed questionnaire and a brief clinical assessment. Its diagnostic capabilities have never been tested in patients with cancer pain. To determine these we conducted a prospective study in outpatients with head and neck cancer. All patients with pain completed the LANSS and underwent a medical assessment with a palliative care physician, whose findings were then reviewed by a pain specialist blinded to the LANSS scores. We assessed acceptability and understanding of the LANSS by patients and calculated the sensitivity and specificity of total LANSS scores and subscores derived from the patient-completed section. Of 130 patients approached, 125 took part. 25 (20%) of these had cancer related pain, mean score on an 11 point numerical rating scale 6.3 (median 6.0, range 3-10). Average age was 60 years (median 60, range 27-84); 56% were male. LANSS completion time was about five minutes, and the procedure was acceptable to all patients. The pain specialist diagnosed neuropathic pain in 14/25 patients, in 13 of whom the neuropathic pain was part of a mixed pain picture. The LANSS correctly identified 11 of these cases (sensitivity 79%; specificity 100%). The patient-completed section alone had a sensitivity of 86% and a specificity of 91%. The LANSS is a simple and suitable screening test for neuropathic pain in patients with head and neck cancer related pain, although some modifications might improve it.

Peripheral neuropathic pain

2010 ◽  
pp. 45-56
Author(s):  
Tim Nash
Keyword(s):  
Neuropathic Pain ◽  
Diabetic Neuropathy ◽  
Cranial Nerves ◽  
Phantom Limb Pain ◽  
Spinal Nerve ◽  
Phantom Limb ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Peripheral Neuropathic Pain ◽  
Symptoms And Signs

Damage to peripheral nerves, including cranial nerves and spinal nerve roots, can result in peripheral neuropathic pain Speed of onset and associated symptoms and signs can point towards possible causes Common conditions include diabetic neuropathy, post-herpetic neuralgia, and post-surgical neuropathies including phantom limb pain Less common conditions result from Guillain-Barr syndrome, deficiency states, and toxic neuropathies...

scholarly journals Cross Cultural Adaptation and Validation of Italian Version of the Leeds Assessment of Neuropathic Symptoms and Signs Scale and Pain DETECT Questionnaire for the Distinction between Nociceptive and Neuropathic Pain

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Alberto Migliore ◽  
Gianfranco Gigliucci ◽  
Antimo Moretti ◽  
Alessio Pietrella ◽  
Marco Peresson ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Internal Consistency ◽  
Nociceptive Pain ◽  
Italian Version ◽  
Good Test ◽  
Retest Reliability ◽  
Outpatient Settings ◽  
Test Retest Reliability ◽  
Bilingual Individual ◽  
Symptoms And Signs

Objective. This study aimed to validate Italian versions of Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale and Pain DETECT questionnaire (PD-Q) and evaluate the ability of these questionnaires to discriminate between nociceptive and neuropathic pain. Design. Multicenter prospective validation cohort study. Subjects and Setting. One hundred patients were included with a diagnosis formulated by a specialist in outpatient settings (50 affected by knee osteoarthritis as nociceptive pain and 50 affected by trigeminal or postherpetic neuralgia as neuropathic pain). Methods. The Italian versions of both questionnaires according to Italian cultural characteristics were performed according to the following steps: (1) translation of the questionnaires from English into Italian; (2) review by a bilingual individual for consistency; (3) proposed version after a mail round between experts; (4) backward translation; (5) comparison with the original English version by the experts; (6) approved version of the questionnaires. One hundred patients were enrolled and completed the two questionnaires administered by a specialist or blinded nursing staff, at the baseline and after 24/48 hours. Internal consistency, stability, validity, and discriminative power were analyzed. Results. Statistically significant differences were reported about the ability of both questionnaires to discriminate between patients affected by neuropathic or nociceptive pain. Internal consistency for the Italian version of the LANSS was 0.76, and for PD-Q, it was 0.80, assessed by Cronbach’s α; LANSS showed a good test-retest reliability with an ICC of 0.76, and PD-Q showed a high test-retest reliability with an ICC of 0.96. For interrater reliability, there was a concordance rate of 83.3% between reference diagnosis and LANSS (Cohen’s kappa = 0.67, CI 95% 0.52–0.75). Conclusions. This study validated the Italian versions of LANSS and PD-Q as reliable instruments with good psychometric characteristics, for pain evaluation, discriminating between nociceptive and neuropathic pain. Our findings were similar to those observed in the original study. Furthermore, we have reported the test-retest reliability for both questionnaires, not addressed in original validation studies.

scholarly journals Part of pain labelled neuropathic in rheumatic disease might be rather nociplastic

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001326
Author(s):  
Florian Bailly ◽  
Alain Cantagrel ◽  
Philippe Bertin ◽  
Serge Perrot ◽  
Thierry Thomas ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Rheumatic Diseases ◽  
Clinical Signs ◽  
Central Sensitisation ◽  
Small Fibre Neuropathy ◽  
Inflammatory Mechanism ◽  
Small Fibre ◽  
Inflammatory Drugs ◽  
The Right ◽  
Symptoms And Signs

Pain in rheumatic diseases is primarily due to mechanical or inflammatory mechanism, but neuropathic pain (NP) component is also occurring in many conditions and is probably underdiagnosed. The purpose of this article is to provide an overview of prevalence, pathophysiological and currently available treatment of NP in rheumatic diseases. When associated with clinical evaluation assessing neurological clinical signs and neuroanatomical distribution, Douleur Neuropathique 4 Questions, painDETECT, Leeds assessment of neuropathic symptoms and signs and Neuropathic Pain Questionnaire can detect NP component. Inflammatory or connective diseases, osteoarthritis, back pain or persistent pain after surgery are aetiologies that all may have a neuropathic component. Unlike nociceptive pain, NP does not respond to usual analgesics such as paracetamol and non-steroidal anti-inflammatory drugs. Entrapment neuropathy, peripheral neuropathy or small-fibre neuropathy are different aetiologies that can lead to NP. A part of the pain labelled neuropathic is rather nociplastic, secondary to a central sensitisation mechanism. Identifying the right component of pain (nociceptive vs neuropathic or nociplastic) could help to better manage pain in rheumatic diseases with pharmacological and non-pharmacological treatments.

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