The Douleur Neuropathique en 4 questions (DN4) questionnaire is used to screen for neuropathic pain. Which set of domains does it assess?

• A Pain quality, sleep disturbance, mood impact, analgesic use
• B Four visual analogue scores recorded over four weeks
• C Seven symptom descriptors plus two items on clinical examination ✓
• D Intensity, duration, frequency and interference with daily activity

Explanation

The DN4 contains ten items scored yes or no: seven interview items covering burning, painful cold, electric shock sensations and associated tingling, pins and needles, numbness and itching, plus two examination items on hypoesthesia to touch and pinprick and one item on whether brushing causes pain. A score of four or more out of ten suggests neuropathic pain. It is not an intensity or disability scale like the Brief Pain Inventory.

Reference: Wall and Melzack's Textbook of Pain, 6th ed.

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