Douleur Neuropathique 4 (DN4)

Clinical intent

The DN4 (which stands for Douleur Neuropathique 4) is one of the questionnaires that can be useful in diagnosing neuropathic pain. It has components of how the pain feels to the patient but also requires the examining health professional to assess whether there is reduced sensation (hypoaesthesia) to touch or pinprick and whether light brushing increases or causes pain (allodynia)[1].

It is a clinician-administered questionnaire consisting of 10 items. Seven items related to pain quality (i.e. sensory and pain descriptors) are based on an interview with the patient and 3 items based on the clinical examination[2].

Calculation

The amount of yesses are counted, can be split up in:

1. Amount of yesses on the patient's interview part (/7)
2. Amount of yesses on the patient's examiniation part (/3)
3. Total amount of yesses / total DN4 score (/10)

Clinical interpretation

The total score ranges from 0 to 100; a high score indicates good outcome.

References

[1] Perez, C., Galvez, R., Huelbes, S. et al. Validity and reliability of the Spanish version of the DN4 (Douleur Neuropathique 4 questions) questionnaire for differential diagnosis of pain syndromes associated to a neuropathic or somatic component. Health Qual Life Outcomes 5, 66 (2007). https://doi.org/10.1186/1477-7525-5-66