Assessing and treating pain associated with stroke, multiple sclerosis, cerebral palsy, spinal cord injury and spasticity. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.
Assessing and treating pain associated with stroke, multiple sclerosis, cerebral palsy, spinal cord injury and spasticity. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.
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评估和治疗与中风、多发性硬化症、脑瘫、脊髓损伤和痉挛相关的疼痛。
DOI：
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发表时间：
2016
影响因子：
4.5
通讯作者：
Stefano Tamburin
中科院分区：
文献类型：
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作者：
S. Paolucci;A. Martinuzzi;G. Scivoletto;N. Smania;C. Solaro;I. Aprile;M. Armando;R. Bergamaschi;E. Berra;G. Bertò;E. Carraro;M. Cella;M. Gandolfi;M. Masciullo;M. Molinari;E. Pagliano;C. Pecchioli;L. Roncari;Monica Torre;E. Trabucco;Gabriella Vallies;P. Zerbinati;Stefano Tamburin
疼痛是中风、多发性硬化症(MS)、脑瘫(CP)、脊髓损伤(SCI)和其他与痉挛相关的疾病患者的常见和致残症状，但关于其患病率、自然病史以及神经康复领域的评估和治疗指南的数据在很大程度上是缺乏的。意大利神经康复疼痛共识会议(ICCPN)搜索和评估了有关中风、MS、CP、SCI和其他与痉挛相关的疾病患者疼痛的频率、演变、预测因素、评估以及药物和非药物治疗的现有证据。卒中、MS、CP和SCI患者可能患有与痉挛有关的疼痛，以及伤害性和神经病理性疼痛(NP)，这些疼痛的患病率、自然病史、对功能结局的影响和预测因素仅部分已知。对这些患者的不同类型的疼痛进行诊断和评估很重要，因为他们的治疗方法可能不同。肉毒神经毒素是治疗痉挛的首选药物，而一些抗抑郁和抗癫痫药物可能对NP有效，但药物治疗因基础疾病而异。在大多数情况下，单一疗法不足以治疗疼痛，需要采取包括药理学和非药理学治疗在内的多学科方法。需要在这些主题上进行进一步的研究，特别是随机对照试验。
Pain is a common and disabling symptom in patients with stroke, multiple sclerosis (MS), cerebral palsy (CP), spinal cord injury (SCI) and other conditions associated with spasticity, but data on its prevalence, and natural history, as well as guidelines on its assessment and treatment in the field of neurorehabilitation, are largely lacking. The Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) searched and evaluated current evidence on the frequency, evolution, predictors, assessment, and pharmacological and non-pharmacological treatment of pain in patients with stroke, MS, CP, SCI and other conditions associated with spasticity. Patients with stroke, MS, CP, and SCI may suffer from pain related to spasticity, as well as nociceptive and neuropathic pain (NP), whose prevalence, natural history, impact on functional outcome, and predictors are only partially known. Diagnosis and assessment of the different types of pain in these patients is important, because their treatment may differ. Botulinum neurotoxin is the first choice treatment for spasticity, while some antidepressant and antiepileptic drugs may be effective on NP, but pharmacological treatment varies according to the underlying disease. In most cases, a single therapy is not sufficient to treat pain, and a multidisciplinary approach, which include pharmacological and non-pharmacological treatments is needed. Further studies, and in particular randomized controlled trials, are needed on these topics.