AAPT Diagnostic Criteria for Peripheral Neuropathic Pain: Focal and Segmental Disorders

Roy Freeman, Robert Edwards, Ralf Baron, Stephen Bruehl, Giorgio Cruccu, Robert H. Dworkin, Simon Haroutounian

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Peripheral neuropathic pain is among the most prevalent types of neuropathic pain. No comprehensive peripheral neuropathic pain classification system that incorporates contemporary clinical, diagnostic, biological, and psychological information exists. To address this need, this article covers the taxonomy for 4 focal or segmental peripheral neuropathic pain disorders, as part of the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership and the American Pain Society (APS) collaborative to develop a standardized, evidence-based taxonomy initiative: the ACTTION-APS Pain Taxonomy (AAPT). The disorders—postherpetic neuralgia, persistent posttraumatic neuropathic pain, complex regional pain disorder, and trigeminal neuralgia—were selected because of their clinical and clinical research relevance. The multidimensional features of the taxonomy are suitable for clinical trials and can also facilitate hypothesis-driven case-control and cohort epidemiologic studies. Perspective: The AAPT peripheral neuropathic pain taxonomy subdivides the peripheral neuropathic pain disorders into those that are generalized and symmetric and those that are focal or segmental and asymmetric. In this article, we cover the focal and segmental disorders: postherpetic neuralgia, persistent posttraumatic neuropathic pain, complex regional pain disorder, and trigeminal neuralgia. The taxonomy is evidence-based and multidimensional, with the following dimensions: 1) core diagnostic criteria; 2) common features; 3) common medical and psychiatric comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors.

Original languageEnglish
Pages (from-to)369-393
Number of pages25
JournalJournal of Pain
Volume20
Issue number4
DOIs
StatePublished - Apr 2019

Keywords

  • Neuropathic pain
  • complex regional pain disorder
  • peripheral neuropathic pain
  • persistent posttraumatic neuropathic pain
  • postherpetic neuralgia
  • trigeminal neuralgia

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