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Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system. [2] [3] Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli . It may have continuous and/or episodic components. The latter resemble stabbings or electric shocks.
Gabapentin is recommended as a first-line treatment for chronic neuropathic pain by various medical authorities. [10] [11] [31] [32] This is a general recommendation applicable to all neuropathic pain syndromes except for trigeminal neuralgia, where it may be used as a second- or third-line agent. [11] [32]
Evidence supports the use of cannabinoids for some forms of neuropathic pain. [98] A 2018 Cochrane review of cannabis-based medicines for the treatment of chronic neuropathic pain included 16 studies. All of these studies included THC as a pharmacological component of the test group. The authors rated the quality of evidence as very low to ...
H3K9 methylation is an important part of the neuropathic pain pathway. The main markers for chronic neuropathic pain are a rise in excitability in primary afferent neurons and a decrease in potassium channel expression in primary sensory neurons. Peripheral nerve damage causes prolonged downregulation of voltage-gated potassium channels.
The oculomotor nerve controls all the muscles that move the eye except for the lateral rectus and superior oblique muscles. It also serves to constrict the pupil and open the eyelid. The onset of a diabetic third nerve palsy is usually abrupt, beginning with frontal or pain around the eye and then double vision. All the oculomotor muscles ...
In 2010, an evidence-based guideline sponsored by the International Association for the Study of Pain recommended nortriptyline as a first-line medication for neuropathic pain. [56] However, in a 2015 Cochrane systematic review the authors did not recommend nortriptyline as a first-line agent for neuropathic pain.