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Neuropathic pain is caused by damage to the parts of the nervous system that normally signal pain. Attempts to classify neuropathic pain patients on the basis of disease etiology or lesion topography have met with limited success, and in this review Ralf Baron presents an alternative system based on molecular mechanisms. He discusses how this approach might lead to the development of more rational treatments for neuropathic pain.
Even in cases of well-controlled type 1 diabetes, cerebral glucose levels are frequently abnormal, and this is thought to have an impact on brain development and function. This article reviews the emerging literature that documents pathophysiological CNS changes and neurocognitive deficits in adults and children with type 1 diabetes, and discusses the implications for the clinical management of these patients.
Skeletal system metastases are the third most common type of metastases in patients with cancer, and metastatic epidural spinal cord compression (MESCC) is estimated to occur in 5–10% of all cancer patients. In this review, Withamet al. discuss current strategies for the clinical management of MESCC, including radiotherapeutic and surgical approaches, and they also consider some emerging treatment options.
In this issue, Ralf Baron has described the molecular mechanisms that underlie neuropathic pain, but how close are we to translating these mechanisms into viable treatment strategies in the clinic? In this accompanying review, Nanna Finnerup and Troels Jensen address this question through a critical evaluation of the mechanism-based approach to neuropathic pain classification.