A Comprehensive Review of Central Post-Stroke Pain

Oh, HyunSoo; Seo, WhaSook

doi:10.1016/j.pmn.2015.03.002

Cited by 53 publications

(54 citation statements)

References 115 publications

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“…DRS patients have suffered a previous stroke and present often, although not exclusively, with thalamic lesions leading to completely debilitating neuropathic pain [1,2,4,5]. The syndrome is thought to be a manifestation of spinothalamic dysfunction, and it has been shown that the relative volume of the spinothalamic pathway in DRS patients is significantly lower than that of controls [6].…”

Section: Introductionmentioning

confidence: 99%

“…The syndrome is thought to be a manifestation of spinothalamic dysfunction, and it has been shown that the relative volume of the spinothalamic pathway in DRS patients is significantly lower than that of controls [6]. Though traditionally characterized as requiring dyesthesia, allodynia, and hyperalgesia [1,2,4,5,7], DRS can also occur in stroke patients with normal sensory processing [8]. While patients can develop DRS with normal sensation, the presence of early evoked pain or dyesthesia in conjunction with reduced cold or pinprick sensations significantly increases the odds of developing DRS [9].…”

Section: Introductionmentioning

confidence: 99%

“…In 2012 Hansen et al [12] proposed that patients suffering from DRS could be identified based on the following criteria [3,5]:…”

Section: Introductionmentioning

confidence: 99%

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Deep Brain Stimulation for the Treatment of Dejerine-Roussy Syndrome

Ward

Mammis²

2017

Stereotact Funct Neurosurg

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Background/Aims: Patients who suffer from Dejerine-Roussy syndrome commonly experience severe poststroke hemibody pain which has historically been attributed to thalamic lesions. Despite pharmacological treatment, a significant proportion of the population is resistant to traditional therapy. Deep brain stimulation is often appropriate for the treatment of resistant populations. In this review we aim to summarize the targets that are used to treat Dejerine-Roussy syndrome and provide insight into their clinical efficacy. Methods: In reviewing the literature, we defined stimulation success as achievement of a minimum of 50% pain relief. Results: Contemporary targets for deep brain stimulation are the ventral posterior medial/ventral posterior lateral thalamic nuclei, periaqueductal/periventricular gray matter, the ventral striatum/anterior limb of the internal capsule, left centromedian thalamic nuclei, the nucleus ventrocaudalis parvocellularis internis, and the posterior limb of the internal capsule. Conclusions: Due to technological advancements in deep brain stimulation, its therapeutic effects must be reevaluated. Despite a lack of controlled evidence, deep brain stimulation has been effectively used as a therapeutic in clinical pain management. Further clinical investigation is needed to definitively evaluate the therapeutic efficacy of deep brain stimulation in treating the drug-resistant patient population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Deep Brain Stimulation for the Treatment of Dejerine-Roussy Syndrome

Ward

Mammis²

2017

Stereotact Funct Neurosurg

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“…Patients can also experience a mixed picture of pain. Post-stroke neuropathic pain is triggered by pathology in the central nervous system leading to functional abnormalities and is labelled as Central Post-Stroke Pain (CPSP) [1]. These problems have a detrimental effect on quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…Increasing research has also demonstrated the benefit of Botulinum Toxin A in the management of neuropathic pain [2]. In the case of CPSP, conventional oral treatments are often ineffective due to systemic side effects and pain can be difficult to control [1].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2017

JNSK

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Purpose: Spasticity and pain are common complications of stroke. Pain following stroke is multi factorial and can be due to musculoskeletal problems, painful spasticity or central post stroke pain. Botulinum Toxin A is the first line pharmacotherapy in spasticity management and increasing evidence has shown benefits in neuropathic pain.Results: This case report demonstrates the benefit of Botulinum Toxin A in the management of central post-stroke pain with elbow flexor spasticity. The clinical characteristics of the pain were neuropathic and the severity was greater than expected given the degree of spasticity. The pain responded to Botulinum Toxin treatment within a few days, independently of the improvement in spasticity and the effect was continued over six cycles of treatment. Conclusion:Management of central post stroke pain is challenging due systemic side effects of oral medications. Botulinum Toxin A has increasingly being shown to benefits in neuropathic pain either through blockade of nociceptive substances or acting on central transmission of pain. Although the treatment in our case was given for spasticity management, the patient had unexpected and significant improvement in pain prior to improvement in range of movement. Given the increasing evidence in use of Botulinum Toxin A in neuropathic pain, we feel this may be a possible future treatment option for central post-stroke pain

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Severe Acute Brain Injury

Isaac

Creutzfeldt

2018

Neuropalliative Care

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A Comprehensive Review of Central Post-Stroke Pain

Cited by 53 publications

References 115 publications

Deep Brain Stimulation for the Treatment of Dejerine-Roussy Syndrome

Deep Brain Stimulation for the Treatment of Dejerine-Roussy Syndrome

Untitled

Severe Acute Brain Injury

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