Guideline "diagnosis and non interventional therapy of neuropathic pain" of the German Society of Neurology (deutsche Gesellschaft für Neurologie).

Amitriptyline Capsaicin Diagnosis Duloxetine Gabapentin Guideline Lidocaine Neuropathic pain Pregabalin Therapy

Journal

Neurological research and practice

ISSN: 2524-3489

Titre abrégé: Neurol Res Pract

Pays: England

ID NLM: 101767802

Informations de publication

Date de publication:
2020

Historique:

received: 16 03 2020

accepted: 03 05 2020

entrez: 16 12 2020

pubmed: 17 12 2020

medline: 17 12 2020

Statut: epublish

Résumé

2019 the DGN (Deutsche Gesellschaft für Neurology) published a new guideline on the diagnosis and non-interventional therapy of neuropathic pain of any etiology excluding trigeminal neuralgia and CRPS (complex regional pain syndrome). Neuropathic pain occurs after lesion or damage of the somatosensory system. Besides clinical examination several diagnostic procedures are recommended to assess the function of nociceptive A-delta and C-Fibers (skin biopsy, quantitative sensory testing, Laser-evoked potentials, Pain-evoked potentials, corneal confocal microscopy, axon reflex testing). First line treatment in neuropathic pain is pregabalin, gabapentin, duloxetine and amitriptyline. Second choice drugs are topical capsaicin and lidocaine, which can also be considered as primary treatment in focal neuropathic pain. Opioids are considered as third choice treatment. Botulinum toxin can be considered as a third choice drug for focal limited pain in specialized centers only. Carbamazepine and oxcarbazepine cannot be generally recommended, but might be helpful in single cases. In Germany, cannabinoids can be prescribed, but only after approval of reimbursement. However, the use is not recommended, and can only be considered as off-label therapy within a multimodal therapy concept.

Identifiants

DOI: 10.1186/s42466-020-00063-3 PMID: 33324922 PMC: PMC7650069

pubmed: 33324922

doi: 10.1186/s42466-020-00063-3

pii: 63

pmc: PMC7650069

doi:

Types de publication

Journal Article

Langues

eng

Pagination

Informations de copyright

Déclaration de conflit d'intérêts

Competing interestsThere are no competing interests.

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