Neuropathic pain is more prevalent in neuropathies associated with prominent involvement of the small unmyelinated and lightly myelinated nerve fibers (the C and Aδ nerve fibers). However, it is not unusual to find neuropathic pain in patients with mixed large-fiber and small-fiber neuropathies and even in neuropathies with predominantly large-fiber involvement. Peripheral neuropathic pain may occur in generalized polyneuropathies, focal peripheral neuropathies (eg, postherpetic neuralgia), mononeuritis multiplex, segmental neuropathies (eg, brachial neuritis), and radiculopathies. Pain results in a substantial proportion of the morbidity associated with a generalized polyneuropathy. This chapter will cover the diagnosis and assessment of the most common and clinically important generalized polyneuropathies that cause neuropathic pain.
Relationship Disclosure: Dr Freeman has received personal compensation for consulting activities from Chelsea Therapeutics, Eli Lilly and Company, Eisai Inc., GlaxoSmithKline, Pfizer Inc, Solace Pharmaceuticals, Takeda Pharmaceutical, UCB, Inc., and XTL Biopharmaceuticals Ltd. Dr Freeman has received personal compensation in an editorial capacity from Autonomic Neuroscience-Basic and Clinical.
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