[Central poststroke pain].
Central poststroke pain is a type of neuropathic pain which is caused by damage to the central nervous system after a stroke and which is localized to the territory of the neurological deficit which corresponds to the cerebrovascular lesion. Stroke is the commonest cause of central neuropathic pain. The purpose of this paper is to draw attention to the importance of this disorder and briefly summarize some clinical aspects and proposed pathophysiological mechanisms on which the rational therapy is based. Due to the lack of randomized controlled trials about the efficacy of the pharmacological treatment, therapeutic guidelines are based also on clinical experience, uncontrolled studies and experts' opinion. According to international guidelines for the treatment of central poststroke pain, the first line therapy is tricyclic antidepressants (amytriptilin and nortriptilin) or antiepileptic drugs (lamotrigine, gabapentine, pregabaline, carbamazepine). The second line is tramadol, opioids and fluvoxamin.
Vurdelja
Ranka Baraba
RB
Opća bolnica "Sveti Duh", Zavod za neurologiju, 10000 Zagreb.
Budincević
Hrvoje
H
Prvan
Miljenka Planjar
MP
D006801:Humans; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D020521:Stroke / Q000150:complications*