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Gepubliceerd in:

2016 | OriginalPaper | Hoofdstuk

3. Klinische herkenning van centrale sensitisatiepijn en differentiaaldiagnostiek met neuropathische en nociceptieve pijn

Auteur : Jo Nijs

Gepubliceerd in: Centrale sensitisatiepijn in de klinische praktijk

Uitgeverij: Bohn Stafleu van Loghum

Samenvatting

Chronische pijnpatiënten vormen een heterogene populatie. Het mag duidelijk zijn dat niet alle chronische pijnpatiënten per definitie een klinisch beeld hebben dat gedomineerd wordt door centrale sensitisatie. Bij medische diagnosen zoals whiplash, fibromyalgie, prikkelbaredarmsyndroom en het chronischevermoeidheidssyndroom, vertonen patiënten typisch dominante centrale sensitisatiepijn. Bij atraumatische chronische nekpijn is er echter weinig tot geen bewijs voor de aanwezigheid van centrale sensitisatie. Patiënten met artrose, tenniselleboog, schouderpijn en lage rugpijn zijn groepen pijnpatiënten waarvan de minderheid een klinisch beeld vertoont dat gedomineerd wordt door centrale sensitisatie. Daarom is goede differentiaaldiagnostiek noodzakelijk.

In dit hoofdstuk reiken we de clinicus praktijkrichtlijnen aan voor de differentiaaldiagnostiek tussen de drie grote pijntypen: dominant nociceptieve, neuropathische en centrale sensitisatiepijn. De klinische werkmethode voor de differentiaaldiagnostiek tussen dominant nociceptieve, neuropathische en centrale sensitisatiepijn bestaat uit twee stappen:

de diagnostiek of uitsluiting van de aanwezigheid van dominant neuropathische pijn;

de differentiaaldiagnostiek tussen dominant nociceptieve en centrale sensitisatiepijn.

Stap 2 omvat het screenen van drie criteria aan de hand van een beslisboom.

In het laatste deel van het hoofdstuk worden deze criteria toegepast op en gespecificeerd voor (1) de lage rugpijnpopulatie en (2) pijn bij/na kanker.

vorige hoofdstuk Wat is centrale sensitisatie en wat zijn de onderliggende mechanismen? Moderne pijnneurowetenschappen voor de klinische praktijk

volgende hoofdstuk Klinisch redeneren bij pijnpatiënten: van diagnostiek tot behandeling aan de hand van een casus

Zie voor het originele document: www.painphysicianjournal.com/2014/september/2014;17;447–457.pdf (gratis te downloaden).

Zie voor het originele document: http://www.painphysicianjournal.com/2015/may/2015;18;E333–E346.pdf (gratis te downloaden).

http://www.paininmotion.be/CSI-consensusvertaling.pdf.

Zie voor meer informatie http://www.paininmotion.be/nieuws-2015-aromatase-inhibitors.html.

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Titel: Klinische herkenning van centrale sensitisatiepijn en differentiaaldiagnostiek met neuropathische en nociceptieve pijn
Auteur: Jo Nijs
Uitgeverij: Bohn Stafleu van Loghum
Boek: Centrale sensitisatiepijn in de klinische praktijk
Print ISBN: 978-90-368-0924-5

Elektronisch ISBN: 978-90-368-0925-2

Copyright: 2016
DOI: https://doi.org/10.1007/978-90-368-0925-2_3

Bohn Stafleu van Loghum

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