Central Neuropathic Pain.

Q1 Medicine

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-10-01 DOI:10.1212/CON.0000000000001490

Charles E Argoff

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引用次数: 0

Abstract

Objective: This article provides an approach to the assessment, diagnosis, and treatment of central neuropathic pain.

Latest developments: Recent studies of the pathophysiology of central neuropathic pain, including evidence of changes in the expression of voltage-gated sodium channels and N-methyl-d-aspartate (NMDA) receptors, may provide the basis for new therapies. Other areas of current research include the role of cannabinoid-receptor activity and microglial cell activation in various animal models of central neuropathic pain. New observations regarding changes in primary afferent neuronal activity in central neuropathic pain and the preliminary observation that peripheral nerve blocks may relieve pain due to central neuropathic etiologies provide new insights into both the mechanism and treatment of central neuropathic pain.

Essential points: In the patient populations treated by neurologists, central neuropathic pain develops most frequently following spinal cord injury, multiple sclerosis, or stroke. A multimodal, individualized approach to the management of central neuropathic pain is necessary to optimize pain relief and may require multiple treatment trials to achieve the best outcome.

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中枢神经痛

目的：本文提供了评估、诊断和治疗中枢神经病理痛的方法：本文提供了一种评估、诊断和治疗中枢神经病理痛的方法：最近对中枢神经病理痛病理生理学的研究，包括电压门控钠通道和 N-甲基-d-天冬氨酸（NMDA）受体表达变化的证据，可为新疗法提供依据。目前的其他研究领域包括大麻素受体活性和小胶质细胞活化在各种中枢神经痛动物模型中的作用。关于中枢性神经病理性疼痛中初级传入神经元活动变化的新观察结果，以及外周神经阻滞可缓解中枢性神经病理性疼痛的初步观察结果，为中枢性神经病理性疼痛的机制和治疗提供了新的见解：要点：在神经科医生治疗的患者群体中，中枢性神经病理性疼痛最常见于脊髓损伤、多发性硬化或中风之后。中枢性神经病理性疼痛的治疗必须采用多模式、个体化的方法，以优化疼痛缓解效果，可能需要多次治疗试验才能达到最佳效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CONTINUUM Lifelong Learning in Neurology Medicine-Medicine (all)

CiteScore

5.80

自引率

0.00%

发文量

175

期刊介绍： Continue your professional development on your own schedule with Continuum: Lifelong Learning in Neurology®, the American Academy of Neurology" self-study continuing medical education publication. Six times a year you"ll learn from neurology"s experts in a convenient format for home or office. Each issue includes diagnostic and treatment outlines, clinical case studies, a topic-relevant ethics case, detailed patient management problem, and a multiple-choice self-assessment examination.