Central pain syndrome
Encyclopedia
Central pain syndrome is a neurological condition caused by damage or malfunction in the Central Nervous System
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...

 (CNS) which causes a sensitization
Sensitization
Sensitization is an example of non-associative learning in which the progressive amplification of a response follows repeated administrations of a stimulus. An everyday example of this mechanism is the repeated tonic stimulation of peripheral nerves that will occur if a person rubs his arm...

 of the pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...

 system. The extent of pain and the areas affected are related to the cause of the injury, which can include trauma
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...

, tumor
Tumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...

s, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...

, Multiple Sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...

, Parkinson's disease
Parkinson's disease
Parkinson's disease is a degenerative disorder of the central nervous system...

, or epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...

 . Pain can either be relegated to a specific part of the body or affect the body as a whole.

Symptoms

Pain is typically constant, may be moderate to severe in intensity, and is often made worse by touch, movement, emotions, and temperature changes, usually cold temperatures. Burning pain is the most common sensation, but patients also report pins and needles
Paresthesia
Paresthesia , spelled "paraesthesia" in British English, is a sensation of tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb "falling asleep"...

, pressing, lacerating, aching, and extreme bursts of sharp pain. Individuals may have reduced sensitivity to touch in the areas affected by the pain. The burning and loss of touch are usually most severe on the distant parts of the body, such as the feet or hands.

Treatment

Treatment includes pharmacological interventions (amitriptyline, mexiletine, lamotrigine) followed by neuromodulation (cortical stimulation, intrathecal drugs such as midazolam and clonidine). Opioids are scarcely effective for CPS and should be reserved to highly selected cases. Ziconotide is sometimes effective but patients should find experienced physicians for treatment.

External links


Further reading

Canavero S, & Bonicalzi V (2007) Central pain syndrome. New York: Cambridge university press (1st ed) ISBN 0521866928 (2011) new edition
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