Turkish Journal of Physical Medicine and Rehabilitation 2005 , Vol 51 , Num 1

Neuropathic Pain and Physiopathological Mechanisms

Ender Berker 1
1 İstanbul Üniversitesi İstanbul Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye

Neuropathic pain, resulting from peripheral and central lesions of the neuronal pain transmission system, is a complex pain syndrome which is often unresponsive to analgesics. Neuropathic pain syndromes are heterogenous in character and cannot be explained by a single etiologic or pathologic mechanism. Neuroanatomic referral of pain, presence of sensory dysfunction associated with peripheral nerve, nerve root, plexus or central tract involvement, and recognition of symptoms and signs such as weakness, muscle atrophy and loss of deep tendon reflexes in mixed nerve traumas are important in the diagnosis of neuropathic pain syndromes. Numerous mechanisms can be responsible in the development of neuropathic pain. Therefore, understanding of the mechanisms operating in individual patients and employment of appropriate therapeutic agents directed towards responsible mechanism(s) rather than symptoms, is essential for treatment success in this complex pain syndrome. Clinical picture and pathophysiological mechanisms of neuropathic pain are discussed in this review.

Keywords : Neuropathic pain, pathophysiology.