Symptoms and pathophysiological mechanisms of neuropathic pain syndromes

Neuropathic pain, caused by various central and peripheral nerve disorders, is especially problematic because of its severity, chronicity, and resistance to simple analgesics. Pathophysiologic changes responsible for generating pain following nerve lesions are usually independent of the etiology of the primary neuronal damage. Several fundamental mechanisms could be identified as principle conditions in the development of neuropathic pain; they include peripheral and central sensitization, disinhibition, sympathetically maintained pain, and cortical reorganization. Classifying neuropathic pain by these basic mechanisms is considered appropriate for basing new treatment approaches. In coming years, several advances are expected in the basic and clinical sciences of neuropathic pain which will provide new and improved therapies for patients continuing to experience this sometimes very disabling condition.