Painful Diabetic Neuropathy in Clinical Practice

by Boulton, Andrew J. M.; Vileikyte, Loretta

• ISBN13: 9780857294876
• ISBN10: 0857294873
• Edition: 1st
• Format: Paperback
• Copyright: 2011-05-29
• Publisher: Springer Verlag

Summary

Painful Diabetic Neuropathy in Clinical Practice provides a concise, didactic and essential resource for clinicians in the management of neuropathic pain in diabetic patients.This volume opens with overviews of epidemiology, classification and clinical features, including a discussion of the negative effect of painful neuropathic symptoms on quality of life. These are followed by a chapter on diagnosis and staging, which includes approaches to history taking, clinical examination, pain assessment scales, testing and staging. The book concludes with a chapter on the various approaches in the management of neuropathic pain, including the most up-to-date guidelines on the pharmacological treatment of this condition.This concise handbook is an invaluable reference for primary care practitioners and diabetologists who wish to keep up to date with the diagnosis and management of neuropathic pain.

Table of Contents

Introduction to Diabetic Neuropathies	p. 1
Definition	p. 1
Epidemiology and Natural History	p. 2
Incidence and Prevalence	p. 2
Risk Factors	p. 3
Natural History	p. 4
References	p. 4
Classification and Clinical Features	p. 7
Classification	p. 7
Sensory Neuropathies	p. 8
Chronic Sensorimotor Distal
Symmetrical Polyneuropathy	p. 8
Acute Sensory Neuropathy	p. 11
The Effects of Painful Neuropathic
Symptoms on Negative Affect and Quality of Life	p. 13
Focal and Multifocal Neuropathies	p. 15
Mononeuropathies	p. 15
Cranial Neuropathies	p. 17
Diabetic Amyotrophy	p. 17
Diabetic Truncal Radiculoneuropathy	p. 18
Chronic Inflammatory Demyelinating
Polyneuropathy	p. 18
Autonomic Neuropathy	p. 19
References	p. 21
Diagnosis and Staging	p. 23
Patient History	p. 23
Patient Description of Pain	p. 25
Positive and Negative Sensory Symptoms	p. 26
Assessment Scales	p. 27
Visual Analogue and Verbal
Descriptor Scales	p. 27
Likert Scales	p. 28
McGill Pain Questionnaire	p. 28
Brief Pain Inventory	p. 28
Neuropathic Pain Scale	p. 28
Leeds Assessment of Neuropathic
Symptoms and Signs Pain Scale	p. 29
NeuroQoL	p. 29
Other Assessment Scales	p. 29
Clinical Examination	p. 30
Quantitative Sensory Testing	p. 30
Electrophysiological Testing	p. 33
Diagnosing Cardiovascular
Autonomic Neuropathy	p. 33
Staging of Neuropathy	p. 35
When to Refer to a Neurologist	p. 36
References	p. 37
Management of Neuropathic Pain	p. 41
Metabolic Control	p. 41
Pharmacological Treatments	p. 43
Tricyclic Antidepressants	p. 43
Selective Serotonin Reuptake Inhibitors	p. 45
Serotonin and Noradrenaline
Reuptake Inhibitors	p. 45
Anticonvulsants	p. 46
Local Anaesthetic/Anti-arrhythmic
Agents	p. 47
Opioids	p. 48
Comparative Trials	p. 49
Topical Treatments	p. 49
Capsaicin	p. 50
Lidocaine Patches	p. 50
Isosorbide Dinitrate Spray	p. 50
Non-pharmacological Treatments	p. 51
Acupuncture	p. 51
Electrical Therapy	p. 51
Treatment of Cardiovascular
Autonomic Neuropathy	p. 52
Guidelines on the Pharmacological Treatment of Diabetic Neuropathic Pain	p. 52
References	p. 54
Index	p. 59
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