Neuropatia Periférica Dolorosa no Diabetes Mellitus:
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DOI:
https://doi.org/10.34024/rnc.2001.v9.8912Palavras-chave:
Diabetes, dor, neuropatiaResumo
Diabetes mellitus é uma doença crônica de elevada prevalência e que apresenta grande número de complicações. A neuropatia diabética é um conjunto complexo e heterogêneo de alterações do sistema nervoso periférico e autonômico com repercussões clínicas variáveis. Dentro do conjunto de alterações neurológicas temos a polineuropatia periférica distal que cursa com quadro doloroso simétrico devido a alterações vasculares, inflamatórias e bioquímicas. A hiperglicemia promove acúmulo de sorbitol e frutose (derivados da glicose) que leva à desmielinização axonal pela diminuição nos níveis de mioinositol, conseqüentemente levando à degeneração neuronal. A abordagem clínica baseia-se na avaliação da dor, que pode ser com testes de clínicos, e/ou na avaliação eletromiográfica. O tratamento farmacológico disponível é sintomático, não reverte nem evita a progressão do quadro. Há várias classes de drogas que podem ser usadas isoladamente ou associadas racionalmente, dentre elas: antidepressivos tricíclicos, anticonvulsivantes, antiarrítmicos, capsaicina tópica, inibidores da aldose redutase, ácido alfa-lipóico e fatores neurotróficos, alguns deles ainda em fase experimental.
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Publicado: 2001-09-30
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