Fig. 5 ∣. Grading system for central neuropathic pain.

A grading system is used to attain different levels of diagnostic certainty for central neuropathic pain (CNP)¹²⁷. If reported symptoms are temporally associated with the lesion or disease and align with the anticipated neuroanatomical pain pattern, the presence of neuropathic pain is possible. To advance to ‘probable’, a neurological examination needs to detect somatosensory abnormalities such as loss of sensation or hypersensitivity. Importantly, differential diagnoses such as musculoskeletal pain must be ruled out at this stage. Once a lesion within the central somatosensory nervous system is confirmed and other types of pain excluded, the definite CNP level is reached.