Clinical features and imaging of central poststroke pain
| Autor: | Ramesh Bhattacharyya, Subrata Goswami, Kartik Chandra Ghosh, Saikat Ghosh, Gouranga Prasad Mondal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Clinical features
imaging central post stroke pain Key message: Central Post Stroke Pain is associated with various sensory symptoms with pain in majority of cases extra thalamic lesions in the sensory pathways were observed in a referral City Hospital in India. Neurology. Diseases of the nervous system RC346-429 |
| Zdroj: | Indian Journal of Pain, Vol 30, Iss 1, Pp 34-37 (2016) |
| Druh dokumentu: | article |
| ISSN: | 0970-5333 |
| DOI: | 10.4103/0970-5333.173462 |
| Popis: | Introduction: Central post stroke pain is a variety of neuropathic pain that occurs after stroke as a result of dysfunction of either spino-thalamic tract or thalamo-cortical sensory pathway. Hyperirritability in surviving cells along the affected pain pathways found with changes in inhibitory pathways, spinal and cortical reorganization and central sensitization. Aim: Clinical features like character of pain and other sensory features with neuroimaging findings of central post stroke pain for a part of Indian population were analyzed in this study. Materials and Method including analysis: 120 numbers of patients, who developed new onset pain symptoms after stroke, attending outpatient and inpatient department of a neurology department during a whole year were examined with history including extensive sensory symptoms analysis; sensory examinations including assessment of pain score and other neurological examinations were done and rechecked by neurologists. All were investigated by neuroimaging with either MRI or CT scan or both. Neuro imaging was interpreted by experienced neuroradiologist and corroborated by neurologists and pain physician. Results: 45% of the lesions were in Thalamus when 75% of the lesions were detected as infarction. 57.5% symptoms started within 3 months. Ataxia found with 60%, increased threshold to warm and cold were seen in 40% of patients, burning sensation was seen in 40% followed by numbness with 20%, dysesthesia found with 60%, reduced sensation to temperature changes found with 40% patients. Conclusion: CPSP patients may presents with various sensory symptoms beside pain. Distribution of sensory symptoms may be with any part of the body as well as over one half of the body. Most common trigger factor was mechanical; while thalamic lesions found in 45%, extra thalamic lesions werefound with 55% of patients. |
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