Central Poststroke Pain: Current Diagnosis and Treatment

Abstract

Central post-stroke pain syndrome (CPSP) is a debilitating sequel that can follow thalamic sensory stroke. Less well recognized, CPSP follows lateral medullary stroke and parietal cortical stroke and may develop anywhere along the spinothalamic or trigemino-thalamic pathways. Patients describe sharp, stabbing, or burning pain and experience hyperpathia and especially allodynia. Although CPSP was first described over 100 years ago, CPSP is too frequently under-recognized. It is treatable disorder. Pharmacological therapy, magnetic stimulation, and invasive electrical stimulation are reviewed and recommendations made.

Keywords:

• central post-stroke pain
• cortical pain
• deep brain stimulation (DBS)
• lateral medullary stroke
• pharmacotherapy
• repetitive transcortical magnetic stimulation (rTMS)
• thalamic pain