An East-West approach to the management of central post-stroke pain.
The development of neuropathic pain following stroke is not uncommon. The consequences include significant disabilities and depression. Treatment can often be difficult and responses unsatisfactory. We report a patient with severe central post-stroke pain (CPSP) of the right leg benefiting from a combination of Western multidisciplinary therapies AND acupuncture. A literature search has revealed that relatively few studies have been done on the management of CPSP, compared with other types of neuropathic pain. Amitriptyline and carbamazepine were found to produce positive effects on post-stroke pain in one small study; lamotrigine and gabapentin are two newer drugs which appear promising. To the best of our knowledge, the use of acupuncture for the treatment of CPSP has not been previously reported.
Yen
Hwee Ling
HL
Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore. hlyen@excite.com
Chan
William
W
D000085:Acetates / Q000627:therapeutic use; D026881:Acupuncture; D000368:Aged; D000588:Amines; D000639:Amitriptyline / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005473:Fluoxetine / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D026741:Physical Therapy Modalities; D020521:Stroke / Q000628:therapy*; D014147:Tramadol / Q000627:therapeutic use; D014227:Triazines / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000701:Analgesics, Opioid; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D014227:Triazines; D005473:Fluoxetine; D000639:Amitriptyline; D014147:Tramadol; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000077213:Lamotrigine