Turkish Journal of Physical Medicine and Rehabilitation 2005 , Vol 51 , Num 2
Central Post-Stroke Pain: Diagnosis and Treatment
Jale İrdesel 1
1 Uludağ Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı,Bursa

Post-stroke central pain (PSCP) is a syndrome characterized by sensory disturbances and neuropathic pain. In addition to chronic pain, the presence of somatosensory abnormal findings is the most important diagnostic indicator of PSCP. The pathophysiology of PSCP remains unknown, but it is generally accepted that damage to the spinothalamic sensory pathways plays a significant role in the pathogenesis of PSCP. This painful state has been estimated to occur in up to 8% of patients after stroke. In most of the patients pain develops in the first month after stroke, but in some patients pain may develop during the six months post-stroke or even later. Problems encountered are often severe and intractable, and treatment is typically difficult. Functional disturbances such as depression, anxiety and sleep disturbances are significant comorbid conditions associated with PSCP. After diagnosis has been made the next clinical stage should be choosing the effective treatment. However, treatment options are limited despite accurately and timely diagnosis. At present, amitriptyline is the drug of first choice. Other drugs including antidepressants, anticonvulsants, antiarrhythmics, opioids and N-methyl-d-aspartate antagonists may provide relief for some patients not responding to amitriptyline. 

Keywords : Poststroke central pain, thalamic pain, treatment