title: Recrudescence of Focal Stroke Symptoms during Pain Management with Hydromorphone.
abstract: Patients who have recovered from a prior stroke may experience a reemergence of their original stroke syndrome secondary to metabolic derangements, sedation, infection, and/or fatigue. Critically, the molecular/cellular mechanisms mediating symptom recurrence after exposure to analgesic agents remain unknown. Accordingly, herein, we report a unique case of a patient with hydromorphone-induced recrudescence 30 years after her initial stroke event(s) and in so doing propose a putative mechanism related to post-infarction functional neuroplasticity.
authors.affiliation: Stroke Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH) , Bethesda, MD , USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Bernstock
authors.affiliation: Department of Anesthesiology, Dwight D. Eisenhower Army Medical Center , Fort Gordon, GA , USA.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Budinich
authors.affiliation: Human Cortical Physiology and Stroke Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH) , Bethesda, MD , USA.
authors.forename: Leonardo G
authors.initials: LG
authors.lastname: Cohen
authors.affiliation: Human Cortical Physiology and Stroke Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH) , Bethesda, MD , USA.
authors.forename: Oluwole O
authors.initials: OO
authors.lastname: Awosika
keywords: opioids; pain management; plasticity; recrudescence of symptoms; stroke