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Don’t fight Central pain syndrome alone.
Find your community on the free RareGuru App.Central pain syndrome (CPS) is a rare neurological disorder caused by damage to or dysfunction of the pain-conducting pathways of the central nervous system (in the brain, brainstem, and spinal cord). Symptoms of CPS can vary greatly from one person to another, partly because the cause may differ. Primary symptoms are pain and loss of sensation, usually in the face, arms, and/or legs. Pain or discomfort may be felt after being touched, or even in the absence of a trigger. The pain may worsen by exposure to heat or cold and by emotional distress. CPS is usually associated with stroke, multiple sclerosis, tumors, epilepsy, brain or spinal cord trauma, or Parkinson's disease. Treatment typically includes pain medications, but complete relief of pain may not be possible. Tricyclic antidepressants or anticonvulsants can sometimes be useful. Lowering stress levels appears to reduce pain.
Many different names have been used for this disorder, including Dejerine- Roussy syndrome, thalamic pain syndrome, central post-stroke syndrome and others. The current name acknowledges that damage to various areas of the central nervous system can cause central pain, and that a stroke is not necessarily the cause. When CPS is due to a stroke, it may be referred to as the more specific term "central post-stroke pain."
Source: GARD Last updated on 05-01-20
Central pain syndrome (CPS) often begins shortly after the injury or damage that caused it. However, it may be delayed by months or even years, especially if it is related to post-stroke pain. The characteristics of the pain associated with CPS differ widely, partly because of the variety of potential causes. It may affect a large portion of the body, or be restricted to specific areas such as the hands or feet.
The severity of pain is usually related to the cause of the central nervous system (CNS) injury or damage. Pain is typically constant, may be moderate to severe in intensity, and is often made worse by touch, movement, emotions, and temperature changes (usually cold temperatures).
People with CPS experience one or more types of pain sensations, the most prominent being burning. Mingled with the burning may be sensations of pins and needles, pressing, lacerating, aching, or brief, intolerable bursts of sharp pain. Some people also experience numbness. The burning and loss-of- touch sensations are usually most severe on the distal parts of the body, such as the feet or hands.
Last updated on 05-01-20
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
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
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