Stroke and central poststroke pain in an elderly population.
Questionnaires about stroke and subsequent pain were administered to 1,071 elderly subjects (median age 80 years, 537 female) by nurses. Seventy-two of the subjects (6.7%) had had completed strokes and 23 (2%) had had transient ischemic attacks. The median age at incidence of both groups was 74 years, and in both groups two thirds of the subjects were men. At least 8 (11%) of the completed stroke subjects had what seemed to be central poststroke pain (CPSP). Their median age at the time of the stroke was 77.5 years; all had a motor deficit. This age was much older than that of a hospital-referred group of 111 CPSP subjects (median age 59 years), of whom only 37% had a motor deficit. It is concluded that large numbers of elderly CPSP victims are not being referred for specialist care. With a CPSP prevalence of 11% at an average stroke age of 75 years in the United Kingdom population of about 3.5 million who are older than 75 years, there would be on the order of 18,000 individuals with CPSP (not counting many younger ones). In comparison with younger hospital-referred cases, CPSP subjects in the present survey appear to have a statistically significant (P =.003) tendency to have nonburning pain and younger ones to have burning pain.
Bowsher
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Pain Research Institute, University Hospital Aintree, Liverpool, L9 7AL, UK. pri@liv.ac.uk