Central Pain Syndrome

What Is Central Pain Syndrome?

Central pain syndrome (CPS) is a neurological condition caused by damage to or dysfunction of the central nervous system (brain or spinal cord). The damage disrupts pain processing, causing persistent pain.¹

Causes²

• Stroke - Post-stroke pain (thalamic pain syndrome)
• Multiple sclerosis
• Spinal cord injury
• Brain tumors
• Parkinson's disease
• Traumatic brain injury
• Epilepsy

Symptoms

• Constant pain, often burning quality
• Intermittent sharp, shooting pain
• Allodynia (pain from light touch)
• Increased sensitivity to temperature
• Pain in area of sensory loss
• May affect large body areas

Characteristics

• Often delayed onset after injury
• Worsened by touch, movement, emotions, weather
• May be accompanied by numbness
• Usually difficult to treat

Treatment³

Medications

• Tricyclic antidepressants (amitriptyline)
• Anticonvulsants (gabapentin, pregabalin)
• Lamotrigine (especially post-stroke)
• Opioids (limited effectiveness)

Other Treatments

• Transcranial magnetic stimulation (TMS)
• Deep brain stimulation
• Motor cortex stimulation
• Physical therapy
• Psychological support

References

1. Klit H, Finnerup NB, Jensen TS. Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet Neurol. 2009;8(9):857-868.
2. Finnerup NB. A review of central neuropathic pain states. Curr Opin Anaesthesiol. 2008;21(5):586-589.
3. Kim JS. Pharmacological management of central post-stroke pain. CNS Drugs. 2014;28(9):787-797.