Managing Odd Neuropathic Pain Disorders

Author: Ignacio Badiola

There are a number of common neuropathic pain syndromes, such as complex regional pain syndrome, postherpetic neuralgia, and diabetic neuropathy, that have established diagnostic and treatment paradigms. There also are a number of neuropathic pain disorders that are as common but less understood and can be more challenging to the treating clinician. For example postthoracotomy pain syndrome is relatively common and is seen in approximately 50% of patients after thoracotomy. It is a chronic condition, and about 30% of patients still experience pain 4 to 5 years after surgery. Between 20% to 60% of women who undergo mastectomy for breast cancer develop postmastectomy pain syndrome. This multidisciplinary panel will review the prevalence, characteristics, and pathophysiology of these odd neuropathic pain disorders and discuss models for evaluation and treatment that include both pharmacologic and nonpharmacologic approaches.

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