Neuropathic itch.
Neuropathic itch.
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DOI：
10.1016/j.sder.2011.04.006
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发表时间：
2011-06
影响因子：
--
通讯作者：
Oaklander, Anne Louise
中科院分区：
文献类型：
--
作者：
Oaklander, Anne Louise
慢性瘙痒可由产生致痒刺激感觉幻觉的瘙痒感应神经元功能障碍引起。其细胞和分子机制仍不清楚。所有神经疾病类别都有牵连，对于原因不明的瘙痒患者应考虑神经病因。导致神经性疼痛的相同神经疾病也可能或者改为引起瘙痒。这些疾病包括带状疱疹（特别是头部或颈部的）、小纤维多发性神经病、神经根病（例如，感觉异常性背痛和臂桡侧瘙痒症）以及三叉神经、神经根和中枢束的多种病变。影响感觉通路的中枢神经系统病变，包括中风、多发性硬化症和海绵状血管瘤，可导致中枢性瘙痒。神经性瘙痒是反射性和自主性搔抓的强烈诱因，尽管搔抓只能带来短暂的缓解。极少数因病变导致感觉丧失以及神经性瘙痒的患者可能会搔抓得足够深，从而造成无痛性自伤。最常见的部位是面部（三叉神经营养综合征）。治疗神经性瘙痒很困难；抗组胺药、皮质类固醇和大多数止痛药基本无效。目前的治疗建议包括局部或全身使用神经元兴奋性抑制剂（尤其是局部麻醉剂）以及设置屏障以减少搔抓。
Chronic itch can be caused by dysfunctions of itch-sensing neurons that produce sensory hallucinations of pruritogenic stimuli. The cellular and molecular mechanisms are still unknown. All neurological disease categories have been implicated and neurological causes should be considered for patients with otherwise-unexplained itch. The same neurological illnesses that cause neuropathic pain can also or instead cause itch. These include shingles (particularly of the head or neck), small-fiber polyneuropathies, radiculopathies (e.g., notalgia paresthetica and brachioradial pruritis) and diverse lesions of the trigeminal nerve, root, and central tracts. Central nervous system lesions affecting sensory pathways, including strokes, multiple sclerosis, and cavernous hemangiomas can cause central itch. Neuropathic itch is a potent trigger of reflex and volitional scratching although this provides only fleeting relief. Rare patients whose lesion causes sensory loss as well as neuropathic itch can scratch deeply enough to cause painless self-injury. The most common location is on the face (trigeminal trophic syndrome). Treating neuropathic itch is difficult; antihistamines, corticosteroids, and most pain medications are largely ineffective. Current treatment recommendations include local or systemic administration of inhibitors of neuronal excitability (especially local anesthetics) and barriers to reduce scratching.
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影响因子：
25
作者：
Andrew, D;Craig, AD
通讯作者：
Craig, AD
DOI：
10.1001/archderm.1933.01460030063005
发表时间：
1933-09-01
影响因子：
--
作者：
Loveman, AB
通讯作者：
Loveman, AB
DOI：
10.1046/j.1468-3083.2001.00146.x
发表时间：
2001-03-01
影响因子：
9.2
作者：
Ferrara, G;Argenziano, G;Delfino, M
通讯作者：
Delfino, M
DOI：
10.1001/jama.1940.02810510020006
发表时间：
1940-10-01
影响因子：
--
作者：
Karnosh, LJ;Scherb, RF
通讯作者：
Scherb, RF
影响因子：
10.3
作者：
ANDREEV, VC;PETKOV, I
通讯作者：
PETKOV, I