Central post-stroke pain

Laijon, G. and Boivie, J. Central post-stroke pain - a controlled trial of amitriptyline and carbamazepine, Pain 1989, 36, 27-36. 

Vick, P. G. and Lamer, T. J. Treatment of central post-stroke pain with oral ketamine, Pain 2001, 92, 311-313. 

Pharmacologic treatment of central post-stroke pain. Clinical Journal of Pain 22 252-260... 

Gastric ulceration and hemorrhage Central post-stroke "thalamic" pain... 

Post-stroke, or thalamic, pain is a burning, severe and paroxysmal pain exacerbated by touch and other stimuli. Such post-stroke pain is rare and usually occurs weeks or months after stroke (Nasreddine and Saver 1997 Frese et al. 2006). There are usually some sensory signs in the affected areas. The lesion is usually located in the contralateral thalamus but may lie elsewhere in the central sensory pathways. Treatment includes anticonvulsants, amitriptyline and various sorts of counter-stimulation but is often unsuccessful. 

Motor cortex stimulation is reserved for the treatment of complex central and neuropathic pain syndromes that have proven refractory to medical treatment, including post-stroke pain, deafferentation pain, and some neuropathic pain states of peripheral origin. 

Neuropathic pain is defined as spontaneous pain and hypersensitivity to pain associated with damage to or pathologic changes in the peripheral nervous system as in painful diabetic peripheral neuropathy (DPN), acquired immunodeficiency syndrome (AIDS), polyneuropathy, post-herpetic neuralgia (PHN) or pain originating in the central nervous system (CNS), that which occurs with spinal cord injury, multiple sclerosis, and stroke. Functional pain, a relatively newer concept, is pain sensitivity due to an abnormal processing or function of the central nervous system in response to normal stimuli. Several conditions considered to have this abnormal sensitivity or hyperresponsiveness include fibromyalgia and irritable bowel syndrome. 

---