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publicado em 26/08/2010 às 22h00:00
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Neuropathic pain is poorly identified by health professionals

Controversies in diagnosis and treatment of disease are the subject of talk at the XXIV Brazilian Congress of Neurology

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Estimates suggest that 10% of Brazilians have neuropathic pain, and with the aging population trend is that this number will increase. The disease results from damage to nerves and can be a consequence of other diseases such as diabetes, vasculitis, inflammation of the nerves, kidney failure etc..

The symptoms are constant burning sensations, pain and shock. Also, are common comorbidities such as sleep disturbance, depression, mood instability, lack of sexual desire, which undermines the very quality of life of patients and their social activities.

All pain is an experience of suffering for man, but the chronic and neuropathic is difficult to control. The diagnosis is complex and doctors should pay attention to the patient's clinical history and, especially, have a good training on the neurologic examination, particularly of the peripheral nervous system. However, few patients who undergo this type of evaluation, explains neurologist Osvaldo Nascimento. The doctor notes that the guidelines for the diagnosis often present controversy, causing confusion on the part of less experienced professionals.

According to the neurologist, to recognize the presentation of the neuropathy is crucial in order to have a proper indication. Many physicians are not well prepared to diagnose the disease. It's a common mistake among them an indication of anti-inflammatory drugs for neuropathic pain. When doctors better understand the disease they will treat it properly, says Dr. Nascimento.

Treatment can be accomplished with dual or tricyclic antidepressants, which work very well in the long term, and it is very common for patients with chronic pain have depression due to the constant state of pain. Depending on side effects of tricyclic antidepressants dual, more modern and duloxetine, are being increasingly used.

Another option for treatment are anticonvulsants, which can also be used in combination with an antidepressant. But when none of these treatments produces the expected effect, ultimately, the doctor uses the indication of opioids. In the case of minor pain, acupuncture works as an alternative treatment, however, the patient should not abandon the guidance of a specialist.

The pain must be understood as a sign of the body that something is wrong. It is important to remember that neuropathic pain is caused by other diseases, and should be investigated and treated.

   Palavras-chave:   Neuropathic Pain    Aging    Pathology    Nerve    Diabetes   
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