Common etiologies of these conditions could be previous trauma, inflammation, tumor invasion, or even from strokes in the thalamic region of the brain. Sometimes there may be no obvious etiology. Some may be due to Chronic Regional Pain Syndrome (CRPS) previously designated Reflex Sympathetic Dystrophy (RSD). If you would search the internet on these conditions you could be busy for weeks.

What causes pain or altered sensations (dysesthesias, hyperesthesias) can be treated by various means. I have used depakote with success. It has some drawbacks with side effects, as do other meds. Other medications that are commonly used are gabapentin (Neurontin), Lyrica, and Trileptal. Phenytoin has been used as well, but not as much since the advent of the newer meds mentioned. These meds fall into the category of cell membrane stabilizers, and as such have been primarily used (and classified) as anti-seizure medications.

Instead of Paxil, which has no effect on neuropathic pain, we commonly use Effexor, Wellbutrin, and Cymbalta. These meds are best known as anti-depressants. There are other antidepressants that are effective as well.

Combinations of medications are the rule of thumb here as no one drug will give adequate relief usually. I am confident that these symptoms can be treated with good success by a Palliative Care expert. Most physicians have no clue how to adequately treat these conditions, having had little or no training in this area. rwh md, ABHPM