Features of diagnosis, treatment and curation of patients with neuropathic pain syndrome of traumatic genesis

Abstract

BACKGROUND: The existing international and national clinical recommendations for the treatment of neuropathic pain syndrome are based mainly on the experience of providing care to patients with non-traumatic genesis of neuropathic pain. Approaches to the diagnosis, treatment and curation patients with neuropathic pain syndrome due damage of the nervous system as a result of wounds received during hostilities may differ from those in patients with somatic diseases.
 AIM: To systematize the features of medical care and improve the methodological approach of curation patients with traumatic neuropathic pain syndrome.
 MATERIALS AND METHODS: The practical experience of providing assistance to the wounded with traumatic lesions of the peripheral nervous system (including patients with phantom pain syndrome) accumulated by the staff of the Department and the Clinic of Nervous Diseases Military Medical Academy for 2022–2023 is summarized.
 RESULTS: The features of inpatient routing, diagnosis, treatment and organization of medical care for patients with traumatic neuropathic pain syndrome at the stage of a specialized medical institution are systematized. The practical aspects of the curation patients with neuropathic pain due to wounds received during hostilities, related to the appointment of medications (including narcotic analgesics), regional anesthesia and the provision of neurosurgical care are highlighted. A separate emphasis is placed on the importance of assessing the mental state and quality of sleep of the wounded with neuropathic pain syndrome, the features of drug correction identified disorders. Practical recommendations for the treatment of patients based on the results of assessing the severity neuropathic pain syndrome using a daily graphic pain diary are presented.
 CONCLUSION: The revealed differences in therapeutic and diagnostic approaches in providing medical care to the wounded with traumatic neuropathic pain syndrome, the importance of interdisciplinary interaction different specialties doctors (neurologists, surgeons, traumatologists, neurosurgeons, psychiatrists) at the early stages of treatment indicate the need to develop separate recommendations for the treatment of neuropathic pain in victims of armed conflicts.