An overview of pain problems associated with lesions, disorder or dysfunction of the central nervous system.
This paper will present an overview of pain problems associated with lesions, disorder or dysfunction of the central nervous system (CNS). The incidence, qualities of the pain experience, associated sensory abnormalities, and other characteristics will be discussed. Particular attention will be paid to central pain (CP) associated with stroke as the most prominent and best studied of the many CP problems. In general, there is poor understanding of the pathophysiology of CP, problems are often severe and intractable, and treatment is typically difficult. The concept of CP is increasingly being invoked to account for various presentations not traditionally considered, e.g. fibromyalgia. It is suggested that processes associated with CP might also contribute to the presentation in psychiatric Pain Disorders or other atypical pain problems. Finally, although perhaps not as problematic, a number of CNS disorders or lesions may be associated with reduced sensitivity to pain.
Nicholson
Keith
K
Comprehensive Pain Program, The Toronto Western Hospital, 4BFell-150, 399 Bathurst St., Toronto, Ontario, Canada M5T 2S8. Tel.: +1 416 603 5800 x2969; Fax: +1 416 603 5725; E-mail: keith@playfair.utoronto.ca