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KMID : 1037820130020020077
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Journal of Pain and Autonomic Disorders
2013 Volume.2 No. 2 p.77 ~ p.83
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Central Pain
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Lee Dong-Kuck
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Abstract
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The term central pain refers to pain caused by a lesion or dysfunction in the central nervous system. Central pain may be caused by vascular lesions, multiple sclerosis, tumors, syringobulbia and syringomyelia, injuries of the brain or the spinal cord. Central mechanisms have also been assumed for pain in Parkinson’s disease. Central pain is a common, poorly understood syndrome which can be explained by the disinhibition hypothesis. All lesions that cause central pain affect the somatosensory pathways. They may be located at any level of the neuraxis. In stroke and spinal cord injuries, the onset of pain is often delayed. In multiple sclerosis, it may be among the first symptoms or start later in the disease, and it some patients it may occur during relapses, at least for some years. Central pain is mostly constant, but it may be intermittent or
paroxysmal, and its intensity differs much between patients. Central pain is correlated with sensory disturbances, dominated by abnormalities in the sensibility to temperature and pain, and hyperesthesias that are often painful, but not with non-sensory neurological symptoms. Central pain is a truly chronic pain that will often last for the rest of the patient’s life, and usually causes the patient much suffering. When drugs are used, increases in dosage should be gradual. It is also wise to inform the patient that the treatment may not relieve the pain completely, which it seldom does. First-line specific treatments are antidepressants, antiepileptics. and transcutaneous electrical nerve stimulation.
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KEYWORD
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Central pain, Chronic pain
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