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Kiadó: The Royal Society of Medicine Press
2005
International Congress and Symposium Series (ICSS) 259
ISBN 1-85315-625-6
ISSN 0142-2367
It is common clinical experience that most diseases affecting the peripheral nervous system do not produce chronic pain but, as expected, lead to negative neurological symptoms and signs, such as low of sensation or weakness. It appears to be paradoxical that damage to the nervous system may cause pain because impairment of nerve fibres carrying nociceptive information in the peripheral or central nervous system should result in a decrease of pain sensibility. Neuropathic pain is not a border in its own right, but the symptom of a wide variety of underlying diseases that require diagnosis by careful neurological examination and appropriate investigations. Understanding why lesions affecting the somatosensory system cause neuropathic pain has been a major challenge for basic and clinical neuroscience for many years. Neuropathic pain currently provides one of the most exciting areas of pain research. The importance of careful clinical studies is highlighted by the fact that several important mechanisms underlying pain in peripheral neuropathies have emerged from investigations of patients and were not predicted by work on animal models of neuropathic pain.
This book summarizes the lectures of a svmposium that brought together authorities who have contributed immensely to our understanding of neuropathic pain. Animal models nave en at the forefront of pain research, but more recently, translational research in human volunteers and patients has flourished. It is therefore timely to examine the human research at has contributed to our understanding of this type of pain. New data from morphological and neurophysiological investigations of nociceptors in patients suffering from neuropathies e demonstrated profound alterations in peripheral nerve disease.
Whereas treatment of neuropathic pain used to been largely empirical, we have recently witnessed a large body of evidence derived from controlled clinical trails that now provides guidance on the effectiveness of diverse medical treatment options. This evidence is critically .appraised in this book and new drugs that are currently under development are highlighted. cal processing of chronic pain is emerging as a fascinating area of pain research; studies functional magnetic resonance imaging have led the way for understanding cerebral processing and perception of pain, as well as providing important insights into the psychological co morbidities that accompany many pain states.
This book is based on presentations given at a symposium held at the Royal Society of Medicine in London in January 2005, by leaders in the field of research in humans into the mechanisms of neuropathic pain. By focusing on human research, we feel that the objective of beginning to develop a coherent account of the neurobiology of neuropathic pain in humans has been achieved. We are grateful to our colleagues who have written the chapters in this book for their clear and accessible accounts of complex neuroscience.