title: Central Neuropathic Pain Syndromes.
abstract: Chronic pain is common in patients with neurologic complications of a central nervous system insult such as stroke. The pain is most commonly musculoskeletal or related to obligatory overuse of neurologically unaffected limbs. However, neuropathic pain can result directly from the central nervous system injury. Impaired sensory discrimination can make it challenging to differentiate central neuropathic pain from other pain types or spasticity. Central neuropathic pain may also begin months to years after the injury, further obscuring recognition of its association with a past neurologic injury. This review focuses on unique clinical features that help distinguish central neuropathic pain. The most common clinical central pain syndromes-central poststroke pain, multiple sclerosis-related pain, and spinal cord injury-related pain-are reviewed in detail. Recent progress in understanding of the pathogenesis of central neuropathic pain is reviewed, and pharmacological, surgical, and neuromodulatory treatments of this notoriously difficult to treat pain syndrome are discussed.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN; Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, MN. Electronic address: Watson.james@mayo.edu.
authors.forename: James C
authors.initials: JC
authors.lastname: Watson
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN.
authors.forename: Paola
authors.initials: P
authors.lastname: Sandroni
mesh_terms: D002493:Central Nervous System Diseases / Q000150:complications*; D059350:Chronic Pain / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*