Neurology 9 - Neuropathic Pain

Question 1

presentation of neuropathic type pain

Answer 1

burning 
tingling
pins and needles
electric shocks
loss of touch sensation to area

Question 2

DDx neuropathic pain

Answer 2

post-herpetic neuralgia after shingles

surgical nerve damage
MS
diabetic foot neuralgia
trigeminal neuralgia

complex regional pain syndrome

Question 3

questionnaire assessing neuropathic pain

Answer 3

DN4 questionnaire

scored out of 10
4+ = NP pain

Question 4

mangement options x 5 neuropathic pain, one is crucial

Answer 4

1. psychological input

amitriptyline (TCA)
duloxetine (SNRI)
gabapentin (anticonv)
pregabalin (anticonv)

Question 5

first line treatment for trigeminal neuralgia

Answer 5

carbamazepine

refer if doesn’t work

Question 6

complex regional pain syndrome

Answer 6

usually one limb
often triggered by injury
can become hypersensitive to any stimulus (e.g. putting on clothes)
may have abnormal colour, temp, flushing, sweating

pain specialist needed