Neurol. praxi. 2015;16(3):155-158

Pregabalin in treatment of neuropathic pain

MUDr. Petr Sperling

Neurologická ambulance Přerov

Neuropathic pain is defined as a pain arising as a direct consequence of a lesion or disease affecting the somatosensory system (Treede, 2008). According to the anatomical localization neuropathic pain can be sorted into central and peripheral and then by etiology. In some cases there can occur both nociceptive and neuropathic component. Neuropathic pain has its specific symptoms and in contrast to nociceptive pain does not require the stimulation of pain receptors, though stimulation of nociceptive receptors can cause or emphasize the neuropathic pain. For patients, it is a symptom that persists and can significantly limit daily life. Therapy of neuropatic pain is complicated and should always be carefully and individually chosen. In terms of pharmacotherapy, antidepressants (SNRI serotonin–norepinephrine reuptake inhibitors and TCA tricyclic antidepressants) and antiepileptics (modulators of α2δ subunit of voltage-gated calcium channels) are recommended as first line therapy and opioids as second line therapy. The two case reports represent patients with neuropathic pain of diabetic origin in the first case and of spinal origin in the second case. These are the ones of the most common types of peripheral neuropathic pain. In both cases pregabalin was chosen as a therapy, in various schemes. Both patients rated the treatment positively, reported a significant improvement of their conditions. However, the treatment was always complete, it was necessary to carefully and gradually titrate the dose or choose a combination of drugs. In the second case, it was included interventional treatment solution.

Keywords: neuropathic pain, proximal diabetic neuropathy, plexo-radiculopathy, adjuvant analgesics, pregabalin

Published: June 26, 2015  Show citation