Differentiating neuropathic pain, opioid-induced hyperalgesia and opioid tolerance; considerations following a remarkable case

Edward G.H. Kenter; Zbigniew Zylicz

Vol 9, No 3 (2010)

Case reports

Published online: 2010-12-27

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Differentiating neuropathic pain, opioid-induced hyperalgesia and opioid tolerance; considerations following a remarkable case

Edward G.H. Kenter, Zbigniew Zylicz

Advances in Palliative Medicine 2010;9(3):93-98.

Vol 9, No 3 (2010)

Case reports

Published online: 2010-12-27

Abstract

Most of the problems in pain control in end of life care are encountered due to three main syndromes or their combinations: neuropathic pain, opioid-induced hyperalgesia and opioid tolerance. In this article, we discuss a patient who was no longer responding to opioids and suffering severe pain, while the opioid dose was very high and still rising. It may be apparent that the three syndromes have a lot in common and their differentiation is not straightforward. However, guidelines can be given for differentiation and a rational approach to treatment.

Adv. Pall. Med. 2010; 9, 3: 93–98

Abstract

Most of the problems in pain control in end of life care are encountered due to three main syndromes or their combinations: neuropathic pain, opioid-induced hyperalgesia and opioid tolerance. In this article, we discuss a patient who was no longer responding to opioids and suffering severe pain, while the opioid dose was very high and still rising. It may be apparent that the three syndromes have a lot in common and their differentiation is not straightforward. However, guidelines can be given for differentiation and a rational approach to treatment.
Adv. Pall. Med. 2010; 9, 3: 93–98

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Keywords

neuropathic pain; hyperalgesia; opioid induced hyperalgesia; opioid tolerance; cancer pain

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Title

Differentiating neuropathic pain, opioid-induced hyperalgesia and opioid tolerance; considerations following a remarkable case

Journal

Advances in Palliative Medicine

Issue

Vol 9, No 3 (2010)

Pages

93-98

Published online

2010-12-27

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670

Article views/downloads

3100

Bibliographic record

Advances in Palliative Medicine 2010;9(3):93-98.

Keywords

neuropathic pain
hyperalgesia
opioid induced hyperalgesia
opioid tolerance
cancer pain

Authors

Edward G.H. Kenter
Zbigniew Zylicz