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首页> 外文期刊>Pain. >A role for peripheral afferents in the pathophysiology and treatment of at-level neuropathic pain in spinal cord injury? A case report.
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A role for peripheral afferents in the pathophysiology and treatment of at-level neuropathic pain in spinal cord injury? A case report.

机译：外周传入神经在脊髓损伤中的水平神经病理性疼痛的病理生理和治疗中是否起作用？病例报告。

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摘要

At-level neuropathic pain is a frequent symptom following spinal cord injury, but the underlying pathophysiology is not completely understood. We report a patient suffering from treatment-resistant at-level pain characterized by ongoing pain and mechanical allodynia for three years after an incomplete spinal lesion. Quantitative sensory testing revealed severe thermosensory deficits in the neuropathic pain area. However, topical application of capsaicin in the neuropathic pain area induced a burning pain sensation, a marked decrease in heat pain threshold and an increase in mechanical allodynia. Treatment with topical lidocaine patches (5%) led to considerable pain relief. These results indicate a functional connection between peripheral, spinal and supraspinal nociceptive pathways and that peripheral afferents may contribute to at-level neuropathic pain after spinal cord injury in this patient. Lesioned peripheral afferents in combination with central neuronal hyperexcitability are discussed as a likely underlying pain mechanism.
机译：水平神经性疼痛是脊髓损伤后的常见症状，但其潜在的病理生理学尚未完全了解。我们报告了一名患者，其在脊椎不完全病变后三年内遭受以治疗为难点的水平疼痛，其特征是持续疼痛和机械性异常性疼痛。定量感觉测试显示神经性疼痛区域严重的热感觉缺陷。然而，辣椒素在神经性疼痛区域的局部应用引起灼痛感，热痛阈值明显降低，机械性异常性疼痛增加。用局部利多卡因贴剂（5％）治疗可明显缓解疼痛。这些结果表明周围，脊髓和脊髓上伤害感受途径之间的功能连接，并且该患者的脊髓损伤后外周传入可能会导致水平的神经性疼痛。病灶周围传入神经与中枢神经元过度兴奋相结合被讨论为可能的潜在疼痛机制。

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