Learning objectives
To know the etiology of neuropathic pain (NP) and the utility of MRI for differential diagnosis.
To provide spectrum of imaging features of these entities.
To analize the future directions of the role of new MRI techniques for characterization if the NP (functional MRI,
Diffusion tensor MRI tractography).
Background
It was defined by IASP (International Association for the Study of Pain) in 1994 as a consequence of injury or disease affecting the somatosensory system.
So NP refers to pain that originates from injury or disfuncion of the nervous system,
including diseases of the peripheral or central nervous system.
The patient with neuropathic pain may have concomitant non-neuropathic pain and it should be consider that NP may be the first manifestation of a systemic disease.
A wide variety of abnormalities can cause NP,
i.e.,
metabolic...
Imaging findings OR Procedure details
Fields in 1991 proposed a classification of NP,
into four groups.
- Mononeuropathy: post-traumatic neuromas,
nerve root compression and idiopathic neuropathies as trigeminal neuralgia.
- Polyneuropathies: ischemic,
metabolic (diabetic neuropathy),
etc.
- Deafferentation pain: postherpetic neuralgia,
amputation neuromas phantom limb pain syndrome and central pain syndrome.
- Complex Regional Pain Syndrome type1 (Reflex Sympathetic Dystrophy –RSD-) and type 2 (Causalgia).
Another classification of NP is based on the location of the lesion:
- Central Nervous System:
Ischemic etiology : Central poststroke pain due to thalamic...
Conclusion
Multiple mechanisms can cause NP.
MRI plays a key role in diagnosis and management of these structural and functional pathologies.
The development of MRI methods will provide a new approach in the study of NP syndromes.
References
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Central poststroke pain: An abstruse outcome
James L Henry,
PhD,Chitra Lalloo,
BHSc,
andKiran Yashpal,
PhD.Pain Res Manag.2008 Jan-Feb;13(1): 41–49.PMCID:PMC2670809
Advances in brain imaging of neuropathic pain
CHEN Fu-yong,
TAO Wei and LI Yong-jieChinese Medical Journal 2008; 121(7):653-657
Brain imaging of neuropathic pain
Xavier Moisset and Didier Bouhassira.NeuroImage 37 (2007) S80–S88
Neuroimaging of pain: what does it tell us?
Karen D.
DavisDOI:10.1097/SPC.0b013e3283458f96
Neuroimaging Studies of Chronic Pain.Do Hyung Kang,
MD,
June...
