central pain syndrome

Introduction

Pain orinating in the CNS.

Etiology

• stroke
• multiple sclerosis
• tumors
• epilepsy
• brain or spinal cord trauma
• Parkinson's disease
• fibromyalgia

Pathology

• damage to or dysfunction of the central nervous system (CNS)
• extent of pain is generally related to the cause of CNS injury

Clinical manifestations

• often begins shortly after the causative injury, but may be delayed by months to years, especially post-stroke pain
• character of the pain differs widely among individuals
• may affect a large part of the body or may be restricted to specific areas, such as hands or feet.
• pain
  • typically constant
  • may be moderate to severe in intensity
  • often made worse by
    • touch
    • movement
    • emotions
    • temperature changes, usually cold temperatures
  • one or more types of pain sensations
    • burning is most prominent pressing
    • paresthesias
    • lacerating, or aching pain
    • brief, intolerable bursts of sharp pain similar to the pain caused by a dental probe on an exposed nerve
• numbness may occur in the areas affected by the pain
• burning & loss of touch sensations are usually most severe on the distant parts of the body, such as the feet or hands

Management

• see neuropathic pain
• analgesics often provide some but incomplete relief of pain
• tricyclic antidepressants i.e. nortryptyline can be useful
• anticonvulsants, i.e. neurontin (gabapentin) can be useful
• lowering stress levels appears to reduce pain
• prognosis
  • not a fatal disorder
  • disabling chronic pain & suffering is most patients

More general terms

• syndrome

More specific terms

• centrally-mediated abdominal pain syndrome (CAPS)
• fibromyalgia syndrome (fibromyositis, fibrositis)

Patient information

central pain syndrome patient information