The International Association for the Study of Pain (IASP) defines neuropathic pain as “Pain initiated or caused by a primary lesion or dysfunction in the nervous system.” It is characterized by spontaneous and or abnormal stimulus-evoked pain (1)
This type of pain, is not nociceptive in nature and nonprotective, persists independent of ongoing tissue injury or inflammation (2).
Alterations in sensation are commonly described in neuropathic pain. These can range from simple hypoaesthesia or numbness to abnormal noxious sensations such as burning (dysaesthesia).
Clinically simple touch becomes a painful stimulus (allodynia), painful responses become magnified (hyperalgesia) and responses to relatively innocuous stimuli are prolonged and exaggerated (hyperpathia). (3)
Children can describe this pain as burning, sharp, shooting (lancinating) or stabbing.
In daily practice neuropathic pain is regularly seen in patients with cancer due to nerve compression or direct invasion from the tumor itself or its metastasis.
Table: Causes of neuropathic pain
Raised intracranial pressure
Spinal cord injury/compression
Traumatic (including iatrogenic) nerve injury
Postsurgical peripheral neuropathic pain
Phantom limb pain
Cancer related neuropathy
Chemotherapy : vinca alkaloid induced neuropathy