Abstract

Neuropathic pains refer to a heterogenous group of pain conditions characterised by lesion or dys- function of the normal sensory pathways. Clinical characteristics include: Delayed onset of pain after nervous system lesion, pain in area of sensory loss, spontaneous and different evoked types of pains. The mechanisms underlying neuropathic pain are not yet clear, apoptosis seems to induce neuronal sensi- tization and loss of inhibitory systems, and these irreversible processes might be in common to nervous system damage by brain trauma or ischemia as well as neuropathic pain. The cellular pathobiology including apoptosis suggests future strategies against neuropathic pain that emphasize preventive aspects. Along these lines, a mechanism-based classification and treatments have recently been proposed, which is an attractive approach because it provides a frame for a rationally based therapy of neuropathic pains. There is currently no consensus concerning the optimal therapeutic strategy for neuropathic pain, despite an increasing number of clinical trials demonstrating successful pain relief with several drugs. An analysis of the various neuropathic symptoms, aimed at selecting treatments targeted at mechanisms, may ultimately help the choice of different pharmacologic agents. Korean Journal of Headache 2(2):99-109, 2001