Central pain is defined as pain that is initiated by a primary lesion within the central nervous system (CNS). Central pain can occur in association with all types of CNS lesions related to a wide variety of pathological processes. However, the probability that a particular lesion will induce central pain is probably less dependent on the type of lesion than on its location in the CNS. One of the classic examples of central pain is the syndrome of thalamic pain related to hemorrhage or infarction of the sensory thalamus.
The highest prevalence of central pain appears to occur after spinal cord injury (30% of patients) and in patients with multiple sclerosis (23% of patients). Although the percentage of patients in whom pain develops after stroke is only approximately 1.5%, stroke itself is so prevalent that the actual number of patients in whom poststroke pain develops is quite large.
Central pain can take many forms
- It can affect large body areas or occur in a very restricted focal pattern.
- Its severity can range from trivial to excruciating.
- It is usually constant and its characteristics are often extremely irritating.
- It can begin immediately after a lesion of the CNS occurs, but it is not unusual for it to be delayed in onset, sometimes not appearing for many months or years after the event.
- Some patients will have spontaneous remission after a period of time, but for the majority the pain persists indefinitely.
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Adapted from Medscape News & Perspective. Motor cortex stimulation for intractable pain. Available at http://www.medscape.com/viewarticle/554867_2 . Accessed on October 12, 2016. To view the entire article and all other content on the Medscape News and Perspective site, a free, one-time registration is required.