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Neuropathic pain

Annette Wessmann

Neuropathic pain is de ned as pain arising as a Chronic neuropathic pain develops mostly
direct consequence of a lesion or disease due to an alteration of the sensory processing
a ecting the somatosensory system and caused by an abnormal peripheral input and
therefore occurs as a consequence of a true abnormal central processing. It can be challeng
insult on the central or peripheral nervous ing to diagnose and to treat, and it is thought to
system rubb, 1 . Pain of non neural origin cause greater impairment of the patient s uality
would not be termed neuropathic, even though of life compared with other pain syndromes
the persistence of any pain can cause plasticity rubb, 1 . he history is particularly
important, as the pain can be intermittent or
and changes in the nervous system this would not obvious such as in central pain pain
be termed neurogenic pain . he sensations experienced in the area of the body subserved
caused by neuropathic pain may include by the lesion originating from a primary lesion of
spontaneous pain, paraesthesia abnormal the CNS . he a ected animal may show obvious
sensation that is not unpleasant such as or subtle changes such as intermittent scratch
tingling, prickling , dysaesthesia unpleasant, ing or attacking an area of the body, fre uent
usually burning sensation , allodynia pain looking at the same area, hiding and reluctance
produced by a stimulus that is not usually to go for walks, yelping for no apparent reason,
painful such as light touch , or hyperalgesia or yelping when petted, or exaggerated response
hyperpathia exaggerated pain response to stimuli that would normally cause only mild
produced by a normally painful stimulus . discomfort athews, 8 .

Author’s perspective
ssessment and treatment of neuropathic pain adapted from onnor and wor in, .
1
1. ake a detailed history and clarify the signs of pain the patient is showing.
. Assess pain on examination and establish a diagnosis of neuropathic pain.
. If possible, identify the cause of the neuropathic pain.

BSAVA Guide to Pain Management in Small Animal Practice. Edited by Ian Self. ©BSAVA 2019 131

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