Central pain syndrome is a neurological disorder caused due to damage to central nervous system which includes the brain, brain stem, thalamus and spinal cord.
Alternate names:
• Thalamic pain syndrome
• Dejerine-Roussy syndrome
• Posterior Thalamic syndrome
• Retrolenticular syndrome
• Central post-stroke syndrome
Cause
Central pain syndrome occurs due to injury to central nervous system caused due to stroke multiple sclerosis, epilepsy, Parkinson’s disease, tumours and trauma to brain or spinal cord. Central pain syndrome usually begins soon after the injury but sometimes it may develop after a long time, may be years especially if the damage is due to stroke.
Symptoms
Central pain syndrome is characterized by a mixture of pain sensation. Pain may be moderate to severe in intensity. Most commonly the pain is described as constant burning pain which increases by light touch. The pain is steady, burning, aching, pressing, lacerating, tearing and mixed with excruciating shots.
There may be a loss of sensation in the affected areas, which is more prominent in distal areas.
Pain is aggravated by temperature changes especially by cold weather. Other factors like exposure to sun, rain, snow, breeze, touch by another person may also increase the pain.
Occasionally, there may be sharp bursts of pain which is similar to pain caused by a dental probe on an exposed nerve.
Treatment
The main goal of treatment is to provide pain relief
• Common analgesics are usually not helpful.
• Some anticonvulsant and antidepressant drugs are helpful in alleviating pain
• Tricyclic antidepressants like nortrytiline are one of the commonly prescribed drugs.
• Anticonvulsant medication especially Gabapentin and Carbamazepine are also helpful.
• Lowering stress level also helps to decrease the pain.
Prognosis
Usually, central pain syndrome requires long term medication as the pain is very disabling and debilitating. Although the disorder is not fatal, the patient usually suffers a lot.
Central cord syndrome
An acute central cord syndrome, shown by disproportionately increased motor skills damage in the upper body compared to the lower body, problems with the bladder, and varying sensory loss below the injury. Diagnosed after the mild trauma has occurred in the event the cervical spondylosis already exists.
Anterior cord syndrome
Lesions that affect the anterior cord, usually points out injury to the anterior artery. When this happens with TSCI, it is thought to the a direct injury instead of a primary disruption of the artery.