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 .