Central pain syndrome

How is central pain syndrome diagnosed?

A diagnosis of central pain syndrome (CPS) is based on the characteristic symptoms, a detailed patient history, a thorough clinical exam and a variety of specialized tests. CPS is suspected in people who complain of pain or other abnormal sensations following injury to the central nervous system. Other conditions that cause pain may need to be ruled out before a diagnosis of CPS is made. The clinical exam may include sensory testing to confirm and pinpoint the presence of sensory abnormalities, but also to rule out other causes of pain. Imaging tests such as a CT scan and MRI may be used to see tumors, infarcts, cerebral bleeding, and other lesions that may cause pain. MRI is the preferred technique when CPS is suspected.

Last updated on 05-01-20

How might central pain syndrome be treated?

Treatment of central pain syndrome (CPS) is known to be challenging. The method of treatment may vary depending on the cause of the neurological damage. Pain medications (analgesics) often provide only some relief of pain.

In general, first-line management includes the use of tricyclic antidepressants such as nortriptyline, anticonvulsants such as gabapentin, or topical lidocaine. Second-line management involves the use of opioid analgesics such as tramadol, along with first-line medication. Third-line management may include other antidepressant or anticonvulsant medications.

Lowering stress levels appears to reduce pain. Other treatment alternatives have included the administration of a sympathetic blockade (a type of nerve block) and a guanethidine block, as well as psychological evaluation and treatment. Rarely, surgery is necessary. Stereotactic radiosurgery of the pituitary has been used with some success. Other forms of potential treatments that have been discussed in the literature include transcutaneous electrical nerve stimulation (TENS); deep brain stimulation; and motor cortex stimulation.

Last updated on 05-01-20

Name: American Chronic Pain Association (ACPA) P.O. Box 850
Rocklin, CA, 95677-0850 , United States
Phone: 916-632-0922 Toll Free: 800-533-3231 Fax : 916-652-8190 Email: ACPA@theacpa.org Url: https://theacpa.org/
Name: American Stroke Association National Center 7272 Greenville Avenue
Dallas, TX, 75231, United States
Phone: 888-478-7653 Url: http://www.strokeassociation.org/
Name: Pain Relief Foundation Clinical Sciences Centre University Hospital Aintree, Lower Lane
Liverpool L9 7AL
United Kingdom
Phone: 0151 529 5820 Fax : 0151 529 5821 Email: secretary@painrelieffoundation.org.uk Url: https://painrelieffoundation.org.uk/
Name: Central Pain Syndrome Foundation CPSF 8760 State Highway 303 NE, #i
Bremerton, WA, 98311,
Phone: (360) 471-3631 Email: info@cps.foundation Url: https://www.cps.foundation/home

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