Revised definition of neuropathic pain and its grading system: an open case series illustrating its use in clinical practice

Am J Med. 2009 Oct;122(10 Suppl):S3-12. doi: 10.1016/j.amjmed.2009.04.005.

Abstract

The definition of neuropathic pain has recently been revised by an expert committee of the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG) as "pain arising as direct consequence of a lesion or disease affecting the somatosensory system," and a grading system of "definite," "probable," and "possible" neuropathic pain has been introduced. This open case series of 5 outpatients (3 men, 2 women; mean age 48 +/- 12 years) demonstrates how the grading system can be applied, in combination with appropriate confirmatory testing, to diagnosis neuropathic conditions in clinical practice. The proposed grading system includes a dynamic algorithm that enhances the physician's ability to determine with a greater level of certainty whether a pain condition is neuropathic. Its clinical use should be further validated in prospective studies.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brown-Sequard Syndrome / complications
  • Brown-Sequard Syndrome / diagnosis
  • Craniomandibular Disorders / complications
  • Craniomandibular Disorders / diagnosis
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Medical History Taking*
  • Middle Aged
  • Neuralgia / diagnosis*
  • Neuralgia / etiology
  • Neuralgia / physiopathology*
  • Neuromyelitis Optica / complications
  • Neuromyelitis Optica / diagnosis
  • Pain / diagnosis
  • Pain / etiology
  • Pain Measurement
  • Physical Examination*
  • Severity of Illness Index
  • Somatoform Disorders / complications
  • Somatoform Disorders / diagnosis
  • Trigeminal Neuralgia / complications
  • Trigeminal Neuralgia / diagnosis
  • Ulnar Neuropathies / complications
  • Ulnar Neuropathies / diagnosis