Symptoms and signs in patients with suspected neuropathic pain
Symptoms and signs in patients with suspected neuropathic pain
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DOI：
10.1016/j.pain.2004.04.034
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发表时间：
2004-07-01
期刊：
影响因子：
7.4
通讯作者：
Bach, FW
中科院分区：
文献类型：
--
作者：
Rasmussen, PV;Sindrup, SH;Bach, FW
该研究试图确定在神经性疼痛（NP）证据增加的患者组中，症状和体征是否有差异。我们前瞻性地观察了214例中重度疑似慢性NP患者的症状和体征。根据一组临床标准，患者被先验地分类为具有所谓的“确定NP”（n = 91）、“可能NP”（n = 71）或“不太可能NP”（n = 52）。记录症状，包括疼痛描述符，五类疼痛的强度，简式麦吉尔疼痛问卷，和抑郁症量表。在最大疼痛区域和对照区域进行感官测试，包括重复针刺刺激、丙酮滴冷诱发疼痛和刷子诱发疼痛检查。高强度的浅表持续性疼痛，触摸或冷引起的疼痛与慢性疼痛相关，归类为明确或可能的神经性。深度持续疼痛和“发作”的强度在三组中相似。在明确的NP中，刷毛诱发的疼痛更常见。麦吉尔疼痛问卷和使用的疼痛描述符无法区分这三种临床类别。虽然某些症状（触摸或冷引起的疼痛）和体征（刷诱发的异常性疼痛）在明确或可能的NP患者中更为突出，但我们发现与不太可能的NP患者的临床表现有相当大的重叠。(C)2004年国际疼痛研究协会。Elsevier B.V.出版，保留所有权利。
The study sought to determine if symptoms and signs cluster differentially in groups of patients with increasing evidence of neuropathic pain (NP). We prospectively looked at symptoms and signs in 214 patients with suspected chronic NP of moderate to severe intensity. According to a set of clinical criteria the patients were a priori classified as having the so-called 'Definite NP' (n = 91), 'Possible NP' (n = 71), or 'Unlikely NP' (n = 52). A recording of symptoms including pain descriptors, intensity of five categories of pain, Short Form McGill Pain Questionnaire, and Major Depression Inventory were done. Sensory tests including repetitive pinprick stimulation, examination for cold-evoked pain by an acetone drop and brush-evoked pain were carried out in the maximal pain area and in a control area. High intensity of superficial ongoing pain, and touch or cold provoked pain was associated with chronic pain classified as definite or possible neuropathic. Intensity of deep ongoing pain, and 'paroxysms' was similar in the three groups. Brush-evoked pain was more frequent in definite NP. The McGill Pain Questionnaire and the used pain descriptors could not distinguish between the three clinical categories. Although certain symptoms (touch or cold provoked pain) and signs (brush-evoked allodynia) are more prominent in patients with definite or possible NP, we found considerable overlap with the clinical presentation of patients with unlikely NP. (C) 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.