Tackling neuropathic pain

Pain is arguably the most common symptom bringing patients to physicians. Neurologists need to be particularly attuned to the nuances of pain symptoms in order to determine whether the pain is due to primary involvement of the nervous system or is a nociceptive or somatic pain that is secondarily transmitted through pain pathways. As our knowledge of the pathophysiology of neuropathic pain becomes more sophisticated, and new treatments are developed, our ability to distinguish different types of neuropathic pain must become more sensitive. Equally important will be our ability to understand the common features of neuropathic pain. Does a treatment found to be effective for pain in diabetic neuropathy or postherpetic neuralgia have an equal likelihood of being therapeutic for neuropathic pain from other peripheral or CNS disorders? The Food and Drug Administration approval of pregabalin and duloxetine for diabetic neuropathic pain and postherpetic neuralgia but the off labeling for otherwise identical neuropathic pain from other causes highlights the importance of answering these questions.

In that context, in this issue of Neurology® the article by Treede et al.¹ is most welcome. It is a consensus report of scientists and clinicians with interest and expertise in peripheral neuropathy …