Pain in acquired demyelinating polyneuropathies

Abstract

Background. Acquired demyelinating polyneuropathies (ADP) are neurological disorders characterized by an autoimmune deficit in the myelin sheath. Pain is one of the most common symptoms seen in ADPs, which has a significant impact on the patient’s quality of life, both physically and mentally, determining the severity of the illness. Objective of the study. To understand the onset, pathophysiology, clinical appearance, evolution, and impact of pain in ADP’s. Material and methods. This narrative literature review uses the relevant terms “pain in acquired demyelinating polyneuropathies” searched on the PubMed database with a publication date of last 10 years, with 21 papers being identified. Results. ADP patients experience acute and chronic pain in varied ways differing in intensity, location, episodes, and duration. Pain may precede peripheral motor and sensory symptoms mimicking other neuropathies and lead to a delayed diagnosis. Pathophysiology verifies aberrant sensory processing, underlying inflammation, and nerve damage by demonstrating the autoimmune deficit in the form of inflammation, axonal injury, and demyelination. Patients may present with nociceptive, neuropathic, or mixed types of pain, with multifactorial mechanisms like ischemia, hypoxia, and immunological complex deposition. Nerve conduction investigations are examples of diagnostic studies that diagnose nerve injury and direct treatment. Diagnosis and management techniques are implemented based on the underlying pathophysiology. Conclusion. Pain in ADP depends on the pathophysiology of the disease and is expressed by its intensity, location, episodes, duration, onset, and evolution. In order to enhance the quality of life for patients physically and psychologically, this literature review attempts to pinpoint the gaps in the present understanding of pathophysiology, diagnostic techniques, and treatment strategies.