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Central Pain and Stroke: A Short Narrative Review

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Detalhes bibliográficos
Resumo:Introduction: Pain can be a sequel of a stroke, and is often undervalued, limiting the patient´s quality of life. This study aimed to make a narrative review on central post stroke pain (CPSP) including its definition, prevalence, clinical presentation, diagnosis, pathophysiology, and treatment. Methods: A search was performed on PubMed© looking for articles in Portuguese or English, with full text, about human research, in adults, using the terms “central” and “pain” and “post stroke”. Thirty-three articles were included in this narrative review. Discussion: CPSP is a neuropathic pain syndrome resulting from an insult to the central nervous system. It is characterized by pain and sensory abnormalities, such as allodynia and hyperalgesia. Prevalence varies from 5% to 50% (thalamic stroke) and it is often underdiagnosed and undertreated. Treatment includes mainly antidepressants and anticonvulsants, and a non- -pharmacological approach. The surgical approach is intended for refractory cases. Conclusion: Management of CPSP is challenging and requires an individualized approach. Future studies may clarify CPSP´s pathophysiology, define clear diagnostic criteria, and collect evidence that allows a more effective treatment.
Autores principais:Reis-Pina, Paulo
Outros Autores:Ramos, Maria Sofia
Assunto:Acidente Vascular Cerebral Dor Neuropática Hiperalgesia Perceção da Dor Sensibilização do Sistema Nervoso Central Central Nervous System Sensitization Hyperalgesia Neuralgia Pain Perception Stroke
Ano:2021
País:portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:Sociedade Portuguesa de Medicina Interna
Idioma:português
Origem:Revista Portuguesa de Medicina Interna
Descrição
Resumo:Introduction: Pain can be a sequel of a stroke, and is often undervalued, limiting the patient´s quality of life. This study aimed to make a narrative review on central post stroke pain (CPSP) including its definition, prevalence, clinical presentation, diagnosis, pathophysiology, and treatment. Methods: A search was performed on PubMed© looking for articles in Portuguese or English, with full text, about human research, in adults, using the terms “central” and “pain” and “post stroke”. Thirty-three articles were included in this narrative review. Discussion: CPSP is a neuropathic pain syndrome resulting from an insult to the central nervous system. It is characterized by pain and sensory abnormalities, such as allodynia and hyperalgesia. Prevalence varies from 5% to 50% (thalamic stroke) and it is often underdiagnosed and undertreated. Treatment includes mainly antidepressants and anticonvulsants, and a non- -pharmacological approach. The surgical approach is intended for refractory cases. Conclusion: Management of CPSP is challenging and requires an individualized approach. Future studies may clarify CPSP´s pathophysiology, define clear diagnostic criteria, and collect evidence that allows a more effective treatment.