ABSTRACT
Neuropathic pain may undoubtedly occur if sensory pathways are damaged, in which case clinical evidence of such damage should be apparent. Certainly, dyskinesia giving rise to abnormal mechanical stress on the axial skeleton may cause radicular pain. Effective treatment of pain in neurologic disease is seldom, if ever, disease specific. Burning central neuropathic pain is probably as likely to respond to a tricyclic antidepressant whether the disorder responsible is syringomyelia, multiple sclerosis, or spinal cord injury. The pharmacologic treatment of neuropathic pain, including topical as well as systemic administration, has been the subject of a recent publication by a Task Force of the European Federation of Neurological Societies. The use of antidepressants in neuropathic pain has been subject to recent systematic review. Beneficial effects of antidepressants on pain have been demonstrated in a wide variety of pain syndromes, including rheumatoid arthritis, low back pain, tension headache, and cancer pain.
