Background And Objectives: Very few texts in the literature approach the neurologic exam of patients with neuropathic pain (NP). The objective of this study was to evaluate the profile of patients with NP through the neurological exam.
Methods: This is an observational study that followed-up patients with NP for one year. The neurologic exam was evaluated at the outpatient clinic and through prospective analysis. Patients whose pain severity was equal or greater than six on the Visual Analogue Scale were included in this study.
Results: Burning pain predominated, affecting 54.5% of the patients. Unlike multifocal neuropathy (15.15%), distal and symmetrical polyneuropathy was the predominant clinical-topographic pattern (48%). The thermoalgic and tactile modalities of the sensorial exam were affected the most, followed by changes in motor function and deep tendon reflexes, and proprioception. Although NP does not have specific signs and symptoms, burning pain is attributed to the involvement of thin nerve fibers and thermoalgic pain is typical of those changes.
Conclusions: History and physical exam findings are key factors in the diagnosis of NP. The log of changes in the physical exam should emphasize the involvement observed, guiding the diagnostic and therapeutic approach, curative or palliative.
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Br J Ophthalmol
January 2025
Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore
Background/aims: To identify the risk factors for neuropathic corneal pain (NCP) following corneal refractive surgery and to report its clinical manifestations, imaging and proteomic characteristics.
Methods: This 1 year prospective cohort study included 100 eyes that underwent small incision lenticule extraction (SMILE) or laser-assisted in situ keratomileusis (LASIK). Ocular surface assessments, in-vivo confocal microscopy scans, tear neuromediators and proteomics analyses were performed.
Gastroenterol Clin North Am
March 2025
Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases & Mech-Sense, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Chronic pancreatitis (CP) is a fibroinflammatory disease, with pain as its most prominent symptom. This article provides a comprehensive review of the pathophysiology, assessment methodologies, and management strategies pertaining to pain in CP. Pathophysiological mechanisms include inflammatory and neuropathic components, including peripheral and central sensitization.
View Article and Find Full Text PDFMol Pharm
January 2025
Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia 23298, United States.
Chemotherapy-induced peripheral neuropathy (CIPN) is a serious side effect of anticancer agents with limited effective preventive or therapeutic interventions. Although fenofibrate, a peroxisome proliferator-activated receptor-alpha (PPARα) agonist, has demonstrated neuroprotective and analgesic properties, its clinical utility is hindered by low receptor affinity, poor subtype selectivity, and suboptimal bioavailability. A190, a highly selective and potent nonfibrate PPARα agonist, offers a promising alternative but is limited by poor aqueous solubility, resulting in reduced oral bioavailability and therapeutic efficacy.
View Article and Find Full Text PDFRheumatology (Oxford)
January 2025
Leeds Institute of Rheumatic and Musculoskeletal Medicine, School of Medicine, University of Leeds, Leeds, UK.
Objectives: Peripheral Sensory Neuropathy (PSN) is an under-recognized feature in systemic sclerosis (SSc). Moreover, SSc foot involvement is frequent but poorly investigated. We aimed to provide a detailed characterization of foot PSN in a large cohort of SSc patients, describing its associations with disease-specific features, physical disability, and Quality of Life (QoL).
View Article and Find Full Text PDFLaeknabladid
February 2025
Department of Neurology, University Hospital of Iceland, Reykjavik, Iceland.
Trigeminal neuralgia is the most common cause of facial pain in individuals over 50 years old and can have a profoundly negative impact on quality of life. Epidemiological studies have measured the annual incidence of trigeminal neuralgia at around 4-5 cases per 100,000 inhabitants per year. In Iceland, this would amount to about 16-20 new cases annually.
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