Translating Neuropathic Pain Diagnosis Into Practice: Clinical, Diagnostic and Therapeutic Skills

Description: This hands-on workshop, Translating Neuropathic Pain Diagnosis into Practice, equips clinicians with essential diagnostic and therapeutic skills for managing neuropathic pain.
Sessions include practical training in focused neurological exams, clinical neurophysiology techniques, and skin biopsy interpretation for evaluating nerve fiber density and autonomic innervation. Pharmacological management is also addressed, combining evidence-based guidelines with real-world strategies for complex cases. Driven by expert clinicians and clinical researchers, the program emphasizes somatosensory, motor, and autonomic assessments, helping participants apply structured diagnostic approaches and tailor treatments effectively. Interactive discussions and case-based learning will enhance understanding of both the capabilities and limitations of current diagnostic and therapeutic tools.

Intended Audience: Clinical Practice, Cross-disciplinary, Clinical Research, Education, Trainee

Theme: Clinical Pain Medicine

Educational Objectives:

• Conduct a comprehensive clinical and neurophysiological assessment for patients with suspected neuropathic pain
• Describe the procedure and clinical relevance of skin biopsies for evaluating intraepidermal nerve fiber density and autonomic innervation in patients with suspected neuropathic pain.
• Apply evidence-based pharmacological strategies for managing neuropathic pain, incorporating current NeuPSIG guidelines as well as individualized approaches not fully addressed in standard protocols.

Please provide the title of each station.: i) Hands-On with Neuropathic Pain: Mastering the Clinical Exam
This hands-on session will demonstrate how to perform a structured clinical examination in patients with suspected neuropathic pain. Following a concise review focused on non-specialist of the anatomy and physiology of the somatosensory system, Daniel Ciampi De Andrade will provide a step-by-step demonstration of a focused neurological exam directed at the diagnosis of neuropathic pain and its main mimics. Emphasis will be placed on assessing somatosensory function, motor function, and identifying autonomic symptoms. The session will also highlight the strengths and limitations of clinical assessment in the context of neuropathic pain.
ii) Clinical Neurophysiology in Neuropathic Pain – Still Relevant?
This hands-on session will explore the usefulness of clinical neurophysiology in diagnosing neuropathic pain. After a brief overview of the diagnostic value of various tests, Andrea Truini will demonstrate the practical application of nerve conduction studies, somatosensory evoked potentials, and trigeminal reflex testing. The session will guide participants in choosing the most appropriate test based on individual patient profiles and clinical suspicion.
iii) Skin Biopsy for Neuropathic Pain – From Sample to Diagnosis
This hands-on demonstration will walk participants through the analysis of skin biopsies used to evaluate intraepidermal nerve fiber density and dermal innervation of autonomic structures such as sweat glands and piloerector muscles. Eleonora Galosi will outline the biopsy processing techniques and explain their diagnostic yield. Real patient samples—both painful and painless neuropathies—will be reviewed and discussed interactively.
iv) Pharmacological Management of Neuropathic Pain – Guidelines and Beyond
In this interactive session, Nadine Attal will discuss the evidence-based pharmacological treatment of neuropathic pain, including the latest NeuPSIG guidelines. Real-world treatment strategies not fully covered by guidelines—such as the use of carbamazepine and oxcarbazepine in trigeminal neuralgia, combination therapy, and sodium channel blockers in erythromelalgia—will also be explored. Participants will be encouraged to share clinical experiences and treatment challenges.

Key Insight Per Station: i) Conduct a comprehensive clinical examination for patients with suspected neuropathic pain, including assessment of somatosensory, motor, and autonomic components of the nervous system.
ii) Select and interpret appropriate neurophysiological tests—such as nerve conduction studies, somatosensory evoked potentials, and trigeminal reflex testing—based on clinical presentation and diagnostic needs.
iii) Describe the procedure and clinical relevance of skin biopsies for evaluating intraepidermal nerve fiber density and autonomic innervation in patients with suspected neuropathic pain.
iv) Apply evidence-based pharmacological strategies for managing neuropathic pain, incorporating current NeuPSIG guidelines as well as individualized approaches not fully addressed in standard protocols.

Speakers

Name	Institution	Country
Daniel Ciampi de Andrade, MD, PhD, doc.med.	Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg Universitet, Aalborg, Denmark.	Denmark