Chapter

Electrophysiology of Pain

Rose M. Dotson and Paola Sandroni

in Clinical Neurophysiology

Third edition

Published on behalf of © Mayo Foundation for Medical Education and Research

Published in print April 2009 | ISBN: 9780195385113
Published online April 2013 | e-ISBN: 9780199322770 | DOI: http://dx.doi.org/10.1093/med/9780195385113.003.0040

Series: Contemporary Neurology Series

Electrophysiology of Pain

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Pain is a subjective experience in which the patient’s emotional state has a major role, contributing to the challenge pain clinicians have in quantifying and objectively evaluating this common complaint. The multiplicity and complexity of the neural mechanisms that produce chronic pain make the clinician’s task even more challenging. During the last 20 years, research in the assessment of the nociceptive and autonomic systems has provided useful tools for the diagnosis, treatment, and scientific investigation of neuropathic pain. QSTs provide an accurate, reproducible assessment of the sensory response to well-delineated controlled stimuli for evaluating the function of small myelinated and unmyelinated fibers. These tests can be useful for documenting sensory disturbances that may occur in patients with neuropathy who experience hypalgesia, hyperalgesia, or allodynia. The inclusion of autonomic tests in the evaluation of some patients with neuropathic pain may provide objective evidence of increased sympathetic tone, heightened somatosympathetic reflexes, or sympathetic denervation. This information may help the clinician to diagnose more accurately the particular type of pain syndrome the patient has so that the treatment may be better directed at the underlying mechanism. MCNG, primarily a research tool, is a powerful method for directly studying primary afferent and sympathetic efferent neural activity in patients with pain caused by lesions of the nervous system. LEPs allow clinicians and researchers to investigate objectively function of the peripheral and central nociceptive pathways in patients with neuropathic pain.

Chapter.  8580 words.  Illustrated.

Subjects: Neurology

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