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Joint European Academy of Neurology–European Pain Federation–Neuropathic Pain Special Interest Group of the International Association for the Study of Pain guidelines on neuropathic pain assessment.

Joint European Academy of Neurology–European Pain Federation–Neuropathic Pain Special Interest Group of the International Association for the Study of Pain guidelines on neuropathic pain assessment.

Authors :
Truini, Andrea
Aleksovska, Katina
Anderson, Christopher C.
Attal, Nadine
Baron, Ralf
Bennett, David L.
Bouhassira, Didier
Cruccu, Giorgio
Eisenberg, Elon
Enax‐Krumova, Elena
Davis, Karen Deborah
Di Stefano, Giulia
Finnerup, Nanna B.
Garcia‐Larrea, Luis
Hanafi, Ibrahem
Haroutounian, Simon
Karlsson, Pall
Rakusa, Martin
Rice, Andrew S. C.
Sachau, Juliane
Source :
European Journal of Neurology. Aug2023, Vol. 30 Issue 8, p2177-2196. 20p.
Publication Year :
2023

Abstract

Background and Purpose: In these guidelines, we aimed to develop evidence‐based recommendations for the use of screening questionnaires and diagnostic tests in patients with neuropathic pain (NeP). Methods: We systematically reviewed studies providing information on the sensitivity and specificity of screening questionnaires, and quantitative sensory testing, neurophysiology, skin biopsy, and corneal confocal microscopy. We also analysed how functional neuroimaging, peripheral nerve blocks, and genetic testing might provide useful information in diagnosing NeP. Results: Of the screening questionnaires, Douleur Neuropathique en 4 Questions (DN4), I‐DN4 (self‐administered DN4), and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) received a strong recommendation, and S‐LANSS (self‐administered LANSS) and PainDETECT weak recommendations for their use in the diagnostic pathway for patients with possible NeP. We devised a strong recommendation for the use of skin biopsy and a weak recommendation for quantitative sensory testing and nociceptive evoked potentials in the NeP diagnosis. Trigeminal reflex testing received a strong recommendation in diagnosing secondary trigeminal neuralgia. Although many studies support the usefulness of corneal confocal microscopy in diagnosing peripheral neuropathy, no study specifically investigated the diagnostic accuracy of this technique in patients with NeP. Functional neuroimaging and peripheral nerve blocks are helpful in disclosing pathophysiology and/or predicting outcomes, but current literature does not support their use for diagnosing NeP. Genetic testing may be considered at specialist centres, in selected cases. Conclusions: These recommendations provide evidence‐based clinical practice guidelines for NeP diagnosis. Due to the poor‐to‐moderate quality of evidence identified by this review, future large‐scale, well‐designed, multicentre studies assessing the accuracy of diagnostic tests for NeP are needed. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13515101
Volume :
30
Issue :
8
Database :
Academic Search Index
Journal :
European Journal of Neurology
Publication Type :
Academic Journal
Accession number :
164722811
Full Text :
https://doi.org/10.1111/ene.15831