Neuropathic Pain Evaluation

A. Validated Screening Tools

  1. DN4 (Douleur Neuropathique 4 Questions)

    • Structure: 10 items (7 symptom-based, 3 clinical exam-based).

    • Scoring: ≥4/10 suggests neuropathic pain.

    • Sensitivity/Specificity: 75–98% and 37–96%, respectively .

    • Strengths: Simple, clinician-administered, validated in multiple languages .

  2. LANSS (Leeds Assessment of Neuropathic Symptoms and Signs)

    • Structure: 5 symptom items + 2 clinical tests (allodynia, pinprick).

    • Scoring: ≥12/24 indicates neuropathic pain.

    • Sensitivity/Specificity: 82–91% and 80–94%, respectively .

    • Self-report version (S-LANSS) available for broader use .

B. Sensory Mapping

  • Allodynia: Pain from non-painful stimuli (e.g., light touch). Common in CRPS, migraines, and postherpetic neuralgia .

  • Hyperalgesia: Exaggerated pain response to normally painful stimuli (e.g., pinprick) .

  • Assessment Methods:

    • Dynamic allodynia: Light brush strokes.

    • Static allodynia: Pressure with a fingertip.

    • Thermal allodynia: Cold/warm stimuli (e.g., tuning fork) .

C. Functional Impact Assessment

  • SALSA Scale: Evaluates activity limitations in leprosy patients but applicable to other neuropathic conditions .

  • WHOQoL-BREF: Assesses quality of life across physical, psychological, and environmental domains .

  • BPI (Brief Pain Inventory): Measures pain severity and interference with daily function .

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