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Chapter 14 - Central post-stroke pain

from Section 4 - The Specific Condition: Central Neuropathic Pain

Published online by Cambridge University Press:  05 December 2013

By
Maan Kattan  and
Dwight E. Moulin
Edited by
Cory Toth  and
Dwight E. Moulin
Cory Toth
Affiliation:
Department of Neurology, University of Calgary
Dwight E. Moulin
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario
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Summary

This chapter discusses the epidemiology, sites of strokes, clinical presentation, pathophysiology, and treatment options for central post-stroke pain (CPSP). CPSP occurs after lesions at any level of the somatosensory pathways of the brain extending from the medulla to the thalamus to the somatosensory cortex. The diagnosis of CPSP is based on a history of stroke followed by pain within an area of the body corresponding to the presumed lesion of the central nervous system with confirmation of the lesion by imaging. The pharmacological and non-pharmacological management of CPSP is challenging and is complicated by comorbid depression, anxiety, and sleep disturbances which are common in this patient population. Tricyclic antidepressants and the anticonvulsant lamotrigine are first-line analgesics in the management of CPSP. Although the prevalence of CPSP is relatively low, the pain can be resistant to treatment and can have a major impact on quality of life.

Keywords

voltage-gated sodium channelpain transmissionpathophysiologyvoltage-gated calcium channelpain managementneuropathic painneurotransmitters
Type
Chapter
Information
Neuropathic Pain
Causes, Management and Understanding
 , pp. 170 - 176
Publisher: Cambridge University Press
Print publication year: 2013

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