Efecto analgésico del parche de capsaicina 8 % a través del receptor vaniloide TRPV-1, en un paciente con enfermedad de Parkinson y dolor neuropático localizado

Nowadays differentiation between central and peripheral origin in Parkinson's disease pain is considered as a clinical challenge. We present a long evolution Parkinson's disease case of a 71 years old woman. Treatment undergone by the patient consists in deep brain stimulation (DBS), drugs dopamine agonist, monoamine oxidase inhibitor-B (MAO-B) and catechol-O-methyltransferase inhibitor (COMT).The patient was referred to the pain unit due to an outbreak of continuous pain in the upper outer region of the left knee and no response to pharmacological nocioceptive pain treatment. The patient was diagnosed with neuropathic pain after reviewing her clinical history, the physical examination and application of the DN4 scale. The chosen treatment was the application of a 179░mg capsaicin patch over the region where she was experiencing the pain and it resulted in an improvement from week one which still persisting twelve weeks later. Treatment with capsaicin patch was selected with the aim of avoid possible drugs interactions with her treatment. As a conclusion, the high topical concentration of capsaicin has been found to be effective and safe in a patient with complicated treatment (DBS plus usual treatment).