Guidelines for Pharmacotherapy of Neuropathic Pain


Authors: J. Bednařík 1,2;  &;  Z. Ambler 1–3,*;  J. Opavský 2,4,*;  O. Keller 1,2,*;  R. Rokyta 4,**;  R. Mazanec 1,**;  J. Lejčko 4,***;  J. Kozák 4,***;  M. Suchý 5,****;  M. Pátá 5,****;  P. Kožený 5,****
Authors‘ workplace: & garant ;  autor *;  konzultant **;  oponent ***;  člen vývojového týmu ****;  Neuromuskulární sekce ČNS ČLS JEP 1;  Česká neurologická společnost ČLS JEP 2;  Neurofarmakologická sekce ČNS ČLS JEP 3;  Společnost pro studium a léčbu bolesti ČLS JEP 4;  Národní referenční centrum 5
Published in: Cesk Slov Neurol N 2012; 75/108(1): 93-101
Category: Treatment Standards

Overview

The guidelines were developed by a Task Force of the Czech Neurological Society and The Czech Pain Society. The major recommendations were adapted from the key international guidelines:  The EFNS guidelines by Attal et al [6] and The guidelines of the Neuropathic Pain Special Interest Group – part of the The International Association for the Study of Pain by Dworkin et al [7]. Level of evidence of all recommendations was classified according to the EFNS classification by Brainin et al [10]. Recommendations were stratified as a treatment of the first, second and third lines, separately for painful polyneuropathies including diabetic polyneuropathy, trigeminal neuralgia, postherpetic neuralgia and other localised peripheral neuropathic pain, central pain, cancer neuropathic pain, HIV neuropathy, neuropathic pain with comorbidities, and recommended combinations of drugs. In addition, the entire process of pharmacological treatment has been defined, including the diagnosis of neuropathic pain, classification, characteristics and mechanisms of action of the drugs used for pharmacotherapy of neuropathic pain.

Key words:
neuropathic pain – pharmacotherapy – painful polyneuropathy – trigeminal neuralgia – postherpetic neuralgia


Sources

1. Dworkin RH, Backonja M, Rowbotham MC, Allen RR, Argoff CR, Bennett GJ et al. Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol 2003; 60(11): 1524–1534.

2. Finnerup NB, Otto M, McQuay HJ, Jensen TS, Sindrup SH. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain 2005; 118(3): 289–305.

3. Attal N, Cruccu G, Haanpää M, Hansson P, Jensen TS, Nurmikko T et al. EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol 2006; 13(11): 1153–1169.

4. Torrance N, Smith BH, Bennett MI, Lee AJ. The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain 2006; 7(4): 281–289.

5. Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain 2008; 136(3): 380–387.

6. Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, Nurmikko T. EFNS guidelines on pharmacological treatment of neuropathic pain: 2009 revision. Eur J Neurol 2010; 17(9): 1113–1123.

7. Dworkin RH, O‘Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS et al. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain 2007; 132(3): 237–251.

8. Cruccu G, Sommer C, Anand P, Attal N, Baron R, Garcia-Larrea L et al. EFNS guidelines on neuropathic pain assessment: revised 2009. Eur J Neurol 2010, 17(8): 1010–1018.

9. National Institute for Health and Clinical Excellence. Neuropathic pain: the pharmacological management of neuropathic pain in adults in non-specialist settings. London: National Institute for Health and Clinical Excellence 2010. Available from: www.nice.org.uk/CG96.

10. Brainin M, Barnes M, Baron JC, Gilhus NE, Hughes R, Selmaj K et al. Guideline Standards Subcommittee of the EFNS Scientific Committee. Guidance for the preparation of neurological management guidelines by EFNS scientific task forces – revised recommenda­tions. Eur J Neurology 2004; 11(9): 577–581.

11. Bednařík J, Voháňka S, Ehler E, Amber Z, Piťha J, Veckovský J et al. Standard pro léčbu pacientů s auto­imunitními nervosvalovými onemocněními intravenózním lidským imunoglobulinem a plazmaferézou. Cesk Slov Neurol N 2010; 73/106(5): 579–589.

12. Treede RD, Jensen TS, Campbell JN, Cruccu G, Ostrovsky JO, Griffin JW et al. Neuropathic pain. Redefinition and a grading system for clinical and research purposes. Neurology 2008; 70(18): 1630–1635.

13. Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP Press 1994.

14. Bennett MI. The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs. Pain 2001; 92: 147–157.

15. Bennett MI, Smith BH, Torrance N, Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain 2005; 6(3): 149–158.

16. Krause SJ, Backonja MM. Development of a neuropathic pain questionnaire. Clin J Pain 2003; 19(5): 306–314.

17. Bouhassira D, Attal N, Alchaar H, Boureau F, Bruxelle J, Cunin G et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic question­naire (DN4). Pain 2005; 114(1–2): 29–36.

18. Freynhagen R, Baron R, Gockel U, Tölle T. PainDetect: a new screeing questionnaire to detect neuropathic components in patients with back pain. Curr Med Res Opin 2006; 22(10): 1911–1920.

19. Portenoy R. Development and testing of a neuropathic pain screening questionnaire: ID Pain. Curr Med Res Opin 2006; 22(8): 1555–1565.

20. Bennett MI, Attal N, Backonja MM, Baron R, Bouhassira D, Freynhagen R et al. Using screening tools to identify neuropathic pain. Pain 2007; 127(3): 199–203.

21. Galer BS, Jensen MP. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology 1997; 48(2): 332–338.

22. Jensen MP, Friedman M, Bonzo D, Richards P. The validity of the neuropathic pain scale for assessing dia­betic neuropathic pain in a clinical trial. Clin J Pain 2006; 22(1): 97–103.

23. Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E et al. Development and validation of the neuropathic pain symptom inventory. Pain 2004; 108(3): 248–257.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 1

2012 Issue 1

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account