Chronic idiopathic axonal neuropathy and pain, treated with the endogenous lipid mediator palmitoylethanolamide: a case collection

Abstract

Chronic idiopathic axonal polyneuropathy is a frequent diagnosis in patients suffering from idiopathic polyneuropathy and neuropathic pain. No guidelines exist on how to treat these patients. To date, there are no results available from randomized clinical trials, and mostly classical neuropathic analgesics are prescribed, such as amitriptyline and gabapentine. However, the usefulness of these drugs is limited, as many patients remain in pain despite treatment, or suffer debilitating side effects. Palmitoylethanolamide (PEA) is a new analgesic compound, tested in more than 4,000 patients in various clinical trials in a variety of patients suffering from various neuropathic pain states. It is available in Europe and the USA as a food supplement under the brand name PeaPure, and it is available for medical purposes in Italy and Spain under brand names Normast and Pelvilen. We present a case series of seven patients with an electrophysiological confirmed diagnosis of chronic idiopathic axonal polyneuropathy, suffering from neuropathic pains, mostly refractory to previous analgesics. In all these patients, PEA reduced pain significantly, without side effects. PEA can be administered in addition to other analgesics, without negative drug–drug interactions, or can be used as a stand-alone analgesic. Due to a favorable ratio between efficacy and safety, PEA should be considered more often as a treatment for neuropathic pain.

Palmitoylethanolamide, a Natural Retinoprotectant: Its Putative Relevance for the Treatment of Glaucoma and Diabetic Retinopathy

“…PEA is a pleiotropic mediator and modulator, having an effect on several receptors ( Figure 1 ) [ 52 ]. Its efficacy and tolerability have been documented in over 40 clinical trials in around 5000 patients and its side-effect profile is very benign [ 53 , 54 ]. However, due to the fact that PEA is available as a nutraceutical, its therapeutic potential is not well recognized in the medical field yet.…”

Delay of Morphine Tolerance by Palmitoylethanolamide

“…PEA exerts antinociceptive effects in several animal models [ 16 , 17 ]. Its safety and efficacy were shown in a variety of clinical trials focused on pain state treatment: diabetic neuropathy, carpal tunnel syndrome, dental and temporomandibular joint pain, and arthritic, postherpetic, and chemotherapy-induced neuropathic pain [ 18 , 19 ]. Moreover, PEA protects nervous tissue in neuropathic conditions [ 20 ], prevents neurotoxicity and neurodegeneration [ 21 , 22 ], and inhibits peripheral inflammation and mast cell degranulation [ 23 ].…”

The Role of Palmitoylethanolamide, an Autacoid, in the Symptomatic Treatment of Muscle Cramps: Three Case Reports and Review of Literature

“…This might be of importance, since certain TRPV1 channel activators have been recently patented for the treatment of muscular cramps [10]. PEA has been evaluated in a number of placebo controlled randomized clinical trials and has been found to be effective in various neuropathic pain states and inflammation [11][12][13][14]. PEA is produced in the body on demand, as all lipid autacoids, and accumulates locally during inflammatory and pain disorders.…”