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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Central post-stroke pain


Other Names for this Disease
  • Central pain syndrome
  • Dejerine Roussy syndrome
  • Posterior thalamic syndrome
  • Retrolenticular syndrome
  • Thalamic hyperesthetic anesthesia
More Names
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Your Question

I had two thalamic strokes in 2009, which left me with chronic pain on my left side. What can I do for this condition?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is central post-stroke pain?

Central post-stroke pain (CPSP) is a rare neurological disorder in which the body becomes hypersensitive to pain as a result of damage to the thalamus, a part of the brain that affects sensation. Primary symptoms are pain and loss of sensation, usually in the face, arms, and/or legs. Pain or discomfort may be felt after being mildly touched or even in the absence of a stimulus; the pain may worsen by exposure to heat or cold and by emotional distress.[1] It is caused by damage to, or dysfunction of, the central nervous system (CNS), which may be due to stroke, multiple sclerosis, tumors, epilepsy, brain or spinal cord trauma, or Parkinson's disease.[2] Treatment typically includes pain medications to provide some reduction of pain, but complete relief of pain may not be possible. Tricyclic antidepressants or anticonvulsants can sometimes be useful. Lowering stress levels appears to reduce pain.[2]
Last updated: 1/24/2011

How might central post-stroke pain be treated?

Treatment of central post-stroke pain (CPSP) is known to be challenging.[3] Pain medications (analgesics) often provide some reduction of pain, but not complete relief of pain. Tricyclic antidepressants such as nortriptyline, or anticonvulsants such as gabapentin can be useful. Lowering stress levels appears to reduce pain.[2] Other treatment alternatives have included the administration of a sympathetic blockade (a type of nerve block) and a guanethidine block, as well as psychological evaluation and treatment. Rarely, surgery is necessary.[4] Stereotactic radiosurgery of the pituitary has been used to treat CPSP with some success.[3] Other forms of potential treatments for CPSP that have been discussed in the literature include transcutaneous electrical nerve stimulation (TENS); deep brain stimulation; and motor cortex stimulation.[5]

Last updated: 1/24/2011

References