Neuropathic Pain in Neurologic Disorders: A Narrative Review

Abstract

Neuropathic pain is defined as a painful condition caused by neurological lesions or diseases. Sometimes, neurological disorders may also be associated with neuropathic pain, which can be challenging to manage. For example, multiple sclerosis (MS) may cause chronic centralized painful symptoms due to nerve damage. Other chronic neuropathic pain syndromes may occur in the form of post-stroke pain, spinal cord injury pain, and other central pain syndromes. Chronic neuropathic pain is associated with dysfunction, disability, depression, disturbed sleep, and reduced quality of life. Early diagnosis may help improve outcomes, and pain control can be an important factor in restoring function. There are more than 100 different types of peripheral neuropathy and those involving sensory neurons can provoke painful symptoms. Accurate diagnosis of peripheral neuropathy is essential for pain control. Further examples are represented by gluten neuropathy, which is an extraintestinal manifestation of gluten sensitivity and presents as a form of peripheral neuropathy; in these unusual cases, neuropathy may be managed with diet. Neuropathic pain has been linked to CoronaVirus Disease (COVID) infection both during acute infection and as a post-viral syndrome known as long COVID. In this last case, neuropathic pain relates to the host's response to the virus. However, neuropathic pain may occur after any critical illness and has been observed as part of a syndrome following intensive care unit hospitalization.

Testosterone and long pulse width stimulation (TLPS) for denervated muscles after spinal cord injury: a study protocol of randomised clinical trial

“…Neuropathic pain is one of the factors that kept participants from being compliant with the study protocol of applying LPWS. 57 Participant noted difficulty in tolerating amplitude of the current >100 mA. Despite the neuropathic pain, the LPWS did not aggravate it and participants were able to finish the 12 months of the study.…”

“…However, patch compliance is monitored by counting the number of returned patches per month throughout the course of the trial. Neuropathic pain is one of the factors that kept participants from being compliant with the study protocol of applying LPWS 57. Participant noted difficulty in tolerating amplitude of the current >100 mA.…”

Assessment of intraepidermal nerve fiber density and neurophysiological studies in patients with idiopathic polyneuropathy

“…There is a significant reduction of intraepidermal nerve fiber density at the distal leg (P < 0.001) between patients with chronic idiopathic polyneuropathy and control groups demonstrating selective degeneration of somatic unmyelinated nerve fibers conveying pain and thermal sensation cannot be observed in routine neurophysiological tests [27], aligning with Pittenger et al [28] who found a significant reduction in IENF (P < 0.001) when comparing control subjects and patients groups in the distal leg of the patients with axonal polyneuropathy.…”

Novel Approach to the Treatment of Neuropathic Pain Using a Combination with Palmitoylethanolamide and Equisetum arvense L. in an In Vitro Study

“…Normally, the somatosensory system allows the perception of touch, pressure, pain, temperature, position, movement, and vibration. Injury or disease can damage peripheral or central nerve fibers by interrupting or altering the pain signals that nerves send and receive from all over the body [ 2 ]. Indeed, NP is caused by chronic lesions or pathologies within the somatosensory nervous system with damage and loss of function of nerve cells [ 3 ].…”