Pain assessment in diabetic polyneuropathy
Keywords:
pain, diabetic polyneuropathy, evaluationAbstract
Pain is an unpleasant emotional state, a major cause of the impaired quality of life of patients with diabetic polyneuropathy. Its diagnosis is a complex and difficult task because it is a subjective feeling of the patient and can be influenced by various factors. Specific scales have been developed which, in combination with neurophysiological methods, help to determine the type of pain and the subsequent medical treatment. The Standardized Evaluation of pain Neuropathic Pain scale not only differentiates the type of pain but also attempts to define a characteristic phenotype of involvement. In this way, it will be possible to differentiate individual subgroups of patients, in search of a specific therapeutic treatment. Clinical symptoms and changes in neurological status in patients with diabetic polyneuropathy may vary, depending on the type of nerve fibers that are affected. The use of neurophysiological methods to objectify damage to small nerve fibers, which are affected in painful forms of polyneuropathy, is limited in Bulgaria. Sudoscan is a non-invasive and rapid method to assess C-fiber function that shows promising data in the diagnosis of painful diabetic polyneuropathy. The test is a potential screening method already in the early stages of the disease. Its combined use with the widely used electroneurography will make possible a comprehensive assessment of the affected fibers in patients. In conclusion, the diagnosis of pain in diabetic polyneuropathy is a complex task, requiring a thorough medical history, clinical examination, as well as the combined use of specific diagnostic pain scales and neurophysiological studies.
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