Central neuropathic pain

Introduction
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By K K Jain MD

Central neuropathic pain is also known as or subsumes Central pain and Neurogenic pain. -ed.

Neuropathic pain is defined as pain initiated or caused by a primary lesion or dysfunction in the nervous system. In this clinical article, Dr. K K Jain, a neurology consultant in Basel, Switzerland, discusses the pathophysiology of central neuropathic pain and its classification and differentiation from peripheral neuropathic pain. There is no satisfactory treatment, but various strategies, both pharmacological and nonpharmacological (including motor cortical stimulation) therapies as well as cell and gene therapies, have been used.

Key points

  • Central neuropathic pain is associated with CNS lesions, eg, stroke and spinal cord injury.
  • Pathophysiology and management of central neuropathic pain is different from that of nociceptive pain.
  • Treatment of central neuropathic pain is still a great challenge.
  • A number of drugs are used with variable degree of effect on neuropathic pain.
  • Neurosurgical procedures such as deep brain stimulation and spinal cord stimulation have been used in intractable cases of central neuropathic pain.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Pregnancy
Anesthesia
References cited
Contributors