Please enable JavaScript.
Coggle requires JavaScript to display documents.
neuropathic pain classification - Coggle Diagram
neuropathic pain classification
neuropathic pain的現狀分類
ICD-11對於chronic neuropathic pain新的分類
更有結構性的分類是必要的
目前為止,只有ICHD有對神經性疼痛有有系統的分類,但是他沒有涵蓋到cranial nerve injuries and neuralgias.
WHO的ICD-10版本,neuropathic pain並沒有充分的represented
few explicit references to conditions of
neuropathic pain in ICD-10.
nternational Statistical Classification of Diseases and Related Health Problems (ICD)
ICD主要是根據etiology, 影響的器官,身體的部位去分類疾病跟症狀
painful condition
acute pain (R52.0)chronic pain(R52.2) chronic intractable pain(R52.1)
diabetic polyneuropathy (G63.2*).
Type 2 diabetes mellitus with neurological complication (E11.4†)
painful diabetic polyneuropathy
classification of chronic neuropathic pain
一些特殊表現的神經性疼痛可以在三個月以內就診斷為慢性神經性疼痛 像是: 三叉神經痛
相同的,像是因為DM造成的polyneuropathic或是spinal cord injury 造成的neuropathic pain, 也不需要等到三個月,就可以診斷為chronic neuropathic pain
老實說,用三個月當作一個界線,只是在一些study或者trail上有一個客觀的界線跟依據。
Fig.1 foundation layer of ICD-11
extension code for pain severity, temporal characteristics, and psychological or social factors
分類可以有跟針對性的治療
簡介neuropathic pain
問卷,是簡單的可以辨認neP跟影響病人程度的方式
PainDetect
2006, 德國, LBP
全部都是病人自己回答問題,不需要檢查
分成三個部分,總分35>
德國
DN4
法國,2004。
https://pubmed.ncbi.nlm.nih.gov/15733628/
160位。 區分neurologic 或者 somatic pain
traumatic nerve injury. PHN, post-stroke pain
somatic: osteoarthritis, inflammatory arthropathies, mechanical low back pain.
LANSS
英國,2001
NPS
Neuropathic Pain Scale (NPS) has been described (Galer and Jensen, 1997) and attempted to discriminate between four diagnostic categories of neuro- pathic pain using single descriptors. Only post-herpetic neuralgia could be distinguished from the other diagnostic groups (re ̄ex sympathetic dystrophy, diabetic neuropathy and peripheral nerve injury). The NPS was not used to discriminate between neuropathic pain and nociceptive pain symptoms
1997,NPS嘗試用區分
表現
A Comprehensive Algorithm for Management of Neuropathic Pain
這篇文章有再進一步分類神經性疼痛嗎?
這篇文章的目的是整合目前對於神經性疼痛的最新處置的導引
圖表
提供第一線到第六線的治療
第一線治療
(tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, gabapentanoids, topicals, and transdermal substances)
第三線治療
serotonin-specific reuptake inhibitors/anticonvulsants/NMDA antagonists and interventional therapies as third-line
第五線治療
low-dose opioids (no greater than 90 morphine equivalent units) are fifth-line; and finally, targeted drug delivery is the last-line therapy for patients with refractory pain.
Stratification of patients based on the Neuropathic Pain Symptom Inventory: development and validation of a new algorithm
再分成三個cluster
pinpointed pain
evoked pain
deep pain
對精神性疼痛的病人有客製化的治療