title: The complexities of pain after stroke--a review with a focus on central post-stroke pain.
abstract: Pain is frequently reported following stroke, but seems to be an underemphasized phenomenon since it can importantly impact rehabilitation and long-term outcomes. Two major forms of pain have to be distinguished in patients with post-stroke pain: central, neuropathic pain, arising from the vascular lesion defined as central post-stroke pain (CPSP) and pain primarily triggered by peripheral mechanisms such as hemiplegic shoulder pain and spasticity-related pain. Headache after stroke is difficult to classify since the pathophysiology is unclear. The suggested underlying mechanisms as well as treatment strategies of post-stroke pain differ according to the origin (peripheral versus central). This article aims at reviewing the pertinent evidence regarding clinical characteristics and mechanisms of post-stroke pain generation with a focus on CPSP. We discuss possible treatment options and highlight current pathophysiological concepts.
authors.affiliation: Department of Neurology, Technische Universität München, Munich, Germany.
authors.forename: C L
authors.initials: CL
authors.lastname: Seifert
authors.forename: M
authors.initials: M
authors.lastname: Mallar Chakravarty
authors.forename: T
authors.initials: T
authors.lastname: Sprenger
mesh_terms: D000818:Animals; D006261:Headache / Q000209:etiology; D006801:Humans; D009128:Muscle Spasticity / Q000209:etiology; D009437:Neuralgia / Q000209:etiology; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011379:Prognosis; D020069:Shoulder Pain / Q000209:etiology; D020521:Stroke / Q000150:complications*