Multilevel symmetric neuropathic pruritus (MSNP) presenting as recalcitrant “generalized” pruritus - 18/09/16
, Vindhya Lakshmi Veerula, MD a, Navid Ezra, MD a, Jeffrey B. Travers, MD, PhD b, c, Nico Mousdicas, MBCHB, MMED, MD aAbstract |
Background |
Chronic itch is a disruptive and disabling condition that can lead to psychological stress and depression.
Objective |
We sought to describe an entity of generalized, symmetric, neuropathic pruritus, which we term “multilevel symmetric neuropathic pruritus,” and offer possible explanations accounting for its pathogenesis.
Methods |
A case series of 14 patients was evaluated at academic institutions from 2011 to 2015.
Results |
All patients exhibited detectable degenerative vertebral changes, as seen by spinal x-ray or magnetic resonance imaging. In 12 of 14 (85.7%) subjects, the radiographic imaging abnormalities directly correlated with the distribution of their cutaneous findings. Twelve of 14 (85.7%) patients had cutaneous findings along the C5 to C6 and/or C6 to C7 dermatomal distributions. Eleven of 14 (78.5%) patients were overweight or obese, and 14 of 14 (100%) patients had at least 4 risk factors for the development of atherosclerosis. Twelve of 14 (85.7%) patients noted complete or near complete resolution after treatment with gabapentin (300-1200 mg daily).
Limitations |
No healthy age-matched control group without pruritus was investigated.
Conclusion |
A combination of multilevel degenerative disc disease of the spine, spinal nerve root impingement, and/or nerve root traction may play a pivotal role in the cause of multilevel symmetric neuropathic pruritus.
Le texte complet de cet article est disponible en PDF.Key words : atherosclerosis, degenerative disc disease, dermatomal, gabapentin, neuropathic, pruritus, symmetric
Abbreviations used : BMI, BRP, DDD, MSNP
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 75 - N° 4
P. 774-781 - octobre 2016 Retour au numéro
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