• Pain · Dec 2013

    Identification of neuropathic pain in patients with neck/upper limb pain: Application of a grading system and screening tools.

    • Brigitte Tampin, Noelle Kathryn Briffa, Roger Goucke, and Helen Slater.
    • School of Physiotherapy and Excercise Science, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia; Department of Physiotherapy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. Electronic address: bvdh@iinet.net.au.
    • Pain. 2013 Dec 1;154(12):2813-22.

    AbstractThe Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain has proposed a grading system for the presence of neuropathic pain (NeP) using the following categories: no NeP, possible, probable, or definite NeP. To further evaluate this system, we investigated patients with neck/upper limb pain with a suspected nerve lesion, to explore: (i) the clinical application of this grading system; (ii) the suitability of 2 NeP questionnaires (Leeds Assessment of Neuropathic Symptoms and Signs pain scale [LANSS] and the painDETECT questionnaire [PD-Q]) in identifying NeP in this patient cohort; and (iii) the level of agreement in identifying NeP between the NeuPSIG classification system and 2 NeP questionnaires. Patients (n = 152; age 52 ± 12 years; 53% male) completed the PD-Q and LANSS questionnaire and underwent a comprehensive clinical examination. The NeuPSIG grading system proved feasible for application in this patient cohort, although it required considerable time and expertise. Both questionnaires failed to identify a large number of patients with clinically classified definite NeP (LANSS sensitivity 22%, specificity 88%; PD-Q sensitivity 64%, specificity 62%). These lowered sensitivity scores contrast with those from the original PD-Q and LANSS validation studies and may reflect differences in the clinical characteristics of the study populations. The diagnostic accuracy of LANSS and PD-Q for the identification of NeP in patients with neck/upper limb pain appears limited.Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

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