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{{Infobox disease
{{Infobox medical condition (new)
| Name = Central pain syndrome
| name = Central pain syndrome
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| ICD9 = {{ICD9|338.0}}
| field = [[Neurology]]
| ICDO =
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| eMedicineSubj =
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'''Central pain syndrome,''' also known as central neuropathic pain,<ref>{{Cite journal |last1=Watson |first1=James |last2=Sandroni |first2=Paola |date=March 2016 |title=Central Neuropathic Pain Syndromes |journal=Mayo Clinic Proceedings |language=en |volume=91 |issue=3 |pages=372–385 |doi=10.1016/j.mayocp.2016.01.017|pmid=26944242 |doi-access=free }}</ref> is a neurological condition consisting of constant moderate to severe pain due to damage to the [[central nervous system]] (CNS) which causes a [[sensitization]] of the [[pain]] system.<ref>{{Cite web |title=Central Pain Syndrome - Symptoms, Causes, Treatment {{!}} NORD |url=https://rarediseases.org/rare-diseases/central-pain-syndrome/ |access-date=2023-08-03 |website=rarediseases.org |language=en-US |archive-date=2018-03-10 |archive-url=https://web.archive.org/web/20180310093543/https://rarediseases.org/rare-diseases/central-pain-syndrome/ |url-status=dead }}</ref><ref>{{Cite journal |last1=Cheng |first1=Jianguo |last2=Ningegowda |first2=Lokesh |last3=Saeed |first3=Pasha |last4=Rosenquist |first4=Rick |date=2013-02-01 |title=Central Pain Syndrome: Pathophysiology, Diagnosis, and Management, Second Edition. |url=https://pubs.asahq.org/anesthesiology/article/118/2/472/13584/Central-Pain-Syndrome-Pathophysiology-Diagnosis |journal=Anesthesiology |language=en |volume=118 |issue=2 |pages=472–473 |doi=10.1097/ALN.0b013e31827d4197 |issn=0003-3022|doi-access=free }}</ref> The extent of pain and the areas affected are related to the cause of the injury.<ref>{{Cite journal |last1=Meacham |first1=Kathleen |last2=Shepherd |first2=Andrew |last3=Mohapatra |first3=Durga |last4=Haroutounian |first4=Simon |date=April 21, 2017 |title=Neuropathic Pain: Central vs. Peripheral Mechanisms |url=http://link.springer.com/10.1007/s11916-017-0629-5 |journal=Current Pain and Headache Reports |language=en |volume=21 |issue=6 |page=28 |doi=10.1007/s11916-017-0629-5 |pmid=28432601 |s2cid=3342368 |issn=1531-3433}}</ref>
'''Central pain syndrome''' is a neurological condition caused by damage or malfunction in the [[Central Nervous System]] (CNS) which causes a [[sensitization]] of the [[pain]] system. The extent of pain and the areas affected are related to the cause of the injury.


==Signs and symptoms==
==Symptoms==
Pain can either be relegated to a specific part of the body or spread to the entire body. It is typically constant, and may be moderate to severe in intensity. It is often made worse by touch, movement, emotions, and temperature changes, usually cold temperatures along with many other similar 'triggers'. Burning pain is the most common sensation, but patients also report [[Paresthesia|pins and needles]], pressing, lacerating, aching, and extreme bursts or constant sharp or unremitting excruciating pain. Individuals may have reduced sensitivity to touch in the areas affected by the pain, as if the part is 'falling asleep'. The burning and loss of [[sense of touch]] are usually, but not always, most severe on the distant parts of the body, such as the feet or hands, spreading until it is in some cases felt from head to toe. For some patients with intense affliction, there often can be unremitting [[nausea]], causing [[vomiting]]. The pain can also bring on [[hyperventilation]]. [[Blood pressure]] can rise due to the pain.<ref>{{Citation
Pain can either be relegated to a specific part of the body or spread to the entire body. It is typically constant, and may be moderate to severe in intensity. Those who are afflicted describe it as being stuck in a loop of pain. It is often made worse by touch, movement, emotions, barometric pressure and temperature changes, usually cold temperatures along with many other similar 'triggers'. Cold temperatures regularly make the burning pain worse in certain body parts. Burning pain is the most common sensation, but patients also report [[Paresthesia|pins and needles]], pressing, lacerating, aching, and extreme bursts or constant sharp or unremitting excruciating pain. Individuals may have reduced sensitivity to touch in the areas affected by the pain, as if the part is 'falling asleep'. The burning and loss of [[sense of touch]] are usually, but not always, most severe on the distant parts of the body, such as the feet or hands, spreading until it is in some cases felt from head to toe. Usually the burning pain in body parts is a result of old injuries that seem like they should have healed long ago, yet the pain lingers on and even years afterwards. For some patients with intense affliction, there often can be unremitting [[nausea]], causing [[vomiting]]. The pain can also bring on [[hyperventilation]]. [[Blood pressure]] can rise due to the pain.<ref>{{Citation
| last =Bowsher
| last =Bowsher
| first =David
| first =David
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| volume =61
| volume =61
| pages =62–69
| pages =62–69
| url =http://jnnp.bmj.com/cgi/content/abstract/61/1/62
| url= | doi =10.1136/jnnp.61.1.62
| pmid =8676164
| doi =10.1136/jnnp.61.1.62
| issue=1}}
| issue=1| pmc =486461
}}
FREE full text. Requires 2 minute registration with BMJ.
FREE full text. Requires 2 minute registration with BMJ.
</ref>
</ref>
Severe cases can result in Intractable Pain, which is defined as a severe, constant pain that is not curable by any known means and which causes a bed or house-bound state and early death if not adequately treated, usually with opioids and/or interventional procedures. It is not relieved by ordinary medical, surgical, nursing, or pharmaceutical measures. Unlike the more common chronic pain, it causes adverse biologic effects on the body's cardiovascular, hormone, and neurologic systems. https://en.m.wikipedia.org/wiki/Intractable_pain


== [[Intractable pain|Cause]] ==
== Cause ==
Damage to the CNS can be caused by car accidents, limb [[amputations]], [[Physical trauma|trauma]], [[spinal cord injury]], [[tumor]]s, [[stroke]], [[immune system disorder]]s or diseases, such as [[Multiple Sclerosis]], [[Parkinson's disease|Parkinson's]], [[Graves disease|Graves]] or [[Addisons Disease|Addison's disease]], [[Rheumatoid arthritis]], and [[epilepsy]].<ref name="NINDS" /> It may develop months or years after injury or damage to the CNS.<ref name="WebMD">{{cite web |url= http://www.webmd.com/pain-management/guide/central-pain-syndrome |title= Pain Management: Central Pain Syndrome |last= Ratini |first= Melinda |date= 2 March 2013 |website= WebMD |publisher= NIH |accessdate=6 February 2014}}</ref>
Damage to the CNS can be caused by car accidents, Physical trauma, [[spinal cord injury]], [[tumor]]s, [[stroke]], or diseases, such as [[multiple sclerosis]], [[Parkinson's disease]], [[Graves disease|Graves]] or [[Addisons Disease|Addison's disease]], and [[epilepsy]].<ref name="NINDS" /> It may develop months or years after injury or damage to the CNS.<ref name="WebMD">{{cite web |url= http://www.webmd.com/pain-management/guide/central-pain-syndrome |title= Pain Management: Central Pain Syndrome |last= Ratini |first= Melinda |date= 2 March 2013 |website= WebMD |publisher= NIH |accessdate=6 February 2014}}</ref>

==Diagnosis==
==Diagnosis==
A diagnosis of central pain syndrome is based upon identification of characteristic symptoms, a detailed patient history, a thorough clinical evaluation and a variety of specialized tests. Central pain syndrome is suspected in individuals who complain of pain or other abnormal sensations following injury to the central nervous system. Other conditions that cause pain may need to be excluded before a diagnosis of central pain syndrome is made.<ref>{{Cite news|url=https://rarediseases.org/rare-diseases/central-pain-syndrome/|title=Central Pain Syndrome - NORD (National Organization for Rare Disorders)|work=NORD (National Organization for Rare Disorders)|access-date=2017-06-08|language=en-US|archive-date=2018-03-10|archive-url=https://web.archive.org/web/20180310093543/https://rarediseases.org/rare-diseases/central-pain-syndrome/|url-status=dead}}</ref>
{{Empty section|date=February 2017}}


== Treatment ==
== Treatment ==
[[Pain medications]] often provide some reduction of pain, but not complete relief of pain, for those affected by central pain syndrome. [[Tricyclic antidepressants]] such as [[nortriptyline]] or [[anticonvulsants]] such as [[neurontin]] (gabapentin) can be useful. Lowering stress levels appears to reduce pain.<ref name="NINDS">{{cite web |url= http://www.ninds.nih.gov/disorders/central_pain/central_pain.htm |title= NINDS Central Pain Syndrome Information Page |author= National Institute of Neurological Disorders and Stroke |date= 13 January 2011 |website= Ninds.nih.gov |publisher= NIH |accessdate=6 February 2014}}</ref> For regular treatment some people prefer body length heating pads while others rely on warm baths, and most any normal 'hot or cold' help.
[[Pain medications]] often provide some reduction of pain, but not complete relief of pain, for those affected by central pain syndrome. [[Tricyclic antidepressants]] such as [[nortriptyline]] or [[anticonvulsants]] such as [[neurontin]] (gabapentin) can be useful, but also provide incomplete relief. Lowering stress levels appears to reduce pain.<ref name="NINDS">{{cite web |url= http://www.ninds.nih.gov/disorders/central_pain/central_pain.htm |title= NINDS Central Pain Syndrome Information Page |author= National Institute of Neurological Disorders and Stroke |date= 13 January 2011 |website= Ninds.nih.gov |publisher= NIH |accessdate= 6 February 2014 |archive-url= https://web.archive.org/web/20140209144930/http://www.ninds.nih.gov/disorders/central_pain/central_pain.htm |archive-date= 9 February 2014 |url-status= dead }}</ref>


== Prognosis ==
== Prognosis ==
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==References==
==References==
{{reflist}}
{{Reflist}}

==Further reading==
==Further reading==
Canavero S, & Bonicalzi V (2007) ''Central pain syndrome''. New York: Cambridge university press (1st ed) {{ISBN|0-521-86692-8}} (2011) new edition
Canavero S, & Bonicalzi V (2007) ''Central pain syndrome''. New York: Cambridge university press (1st ed) {{ISBN|0-521-86692-8}} (2011) new edition


==External links==
== External links ==
{{Medical resources
*[http://www.webmd.com/pain-management/guide/central-pain-syndrome WebMD] - A concise 4 paragraph description of the condition.
| DiseasesDB =
⚫
*[http://www.ninds.nih.gov/disorders/central_pain/central_pain.htm USA National Institute of Neurological disorders and Stroke] - Authoritative 4 paragraphs on central pain.
| ICD10 = {{ICD10|G89.0}}

| ICD9 = {{ICD9|338.0}}
| ICDO =
| OMIM =
| MedlinePlus =
⚫
| eMedicineSubj =
⚫
| eMedicineTopic =
| MeshID =
}}
⚫
* [https://web.archive.org/web/20090708224215/http://www.ninds.nih.gov/disorders/central_pain/central_pain.htm USA National Institute of Neurological disorders and Stroke] - Authoritative 4 paragraphs on central pain.


{{Authority control}}


[[Category:Chronic pain syndromes]]
[[Category:Chronic pain syndromes]]
[[Category:Central nervous system disorders]]

Latest revision as of 01:24, 29 November 2024

Central pain syndrome
SpecialtyNeurology

Central pain syndrome, also known as central neuropathic pain,[1] is a neurological condition consisting of constant moderate to severe pain due to damage to the central nervous system (CNS) which causes a sensitization of the pain system.[2][3] The extent of pain and the areas affected are related to the cause of the injury.[4]

Signs and symptoms

[edit]

Pain can either be relegated to a specific part of the body or spread to the entire body. It is typically constant, and may be moderate to severe in intensity. Those who are afflicted describe it as being stuck in a loop of pain. It is often made worse by touch, movement, emotions, barometric pressure and temperature changes, usually cold temperatures along with many other similar 'triggers'. Cold temperatures regularly make the burning pain worse in certain body parts. Burning pain is the most common sensation, but patients also report pins and needles, pressing, lacerating, aching, and extreme bursts or constant sharp or unremitting excruciating pain. Individuals may have reduced sensitivity to touch in the areas affected by the pain, as if the part is 'falling asleep'. The burning and loss of sense of touch are usually, but not always, most severe on the distant parts of the body, such as the feet or hands, spreading until it is in some cases felt from head to toe. Usually the burning pain in body parts is a result of old injuries that seem like they should have healed long ago, yet the pain lingers on and even years afterwards. For some patients with intense affliction, there often can be unremitting nausea, causing vomiting. The pain can also bring on hyperventilation. Blood pressure can rise due to the pain.[5]

Cause

[edit]

Damage to the CNS can be caused by car accidents, Physical trauma, spinal cord injury, tumors, stroke, or diseases, such as multiple sclerosis, Parkinson's disease, Graves or Addison's disease, and epilepsy.[6] It may develop months or years after injury or damage to the CNS.[7]

Diagnosis

[edit]

A diagnosis of central pain syndrome is based upon identification of characteristic symptoms, a detailed patient history, a thorough clinical evaluation and a variety of specialized tests. Central pain syndrome is suspected in individuals who complain of pain or other abnormal sensations following injury to the central nervous system. Other conditions that cause pain may need to be excluded before a diagnosis of central pain syndrome is made.[8]

Treatment

[edit]

Pain medications often provide some reduction of pain, but not complete relief of pain, for those affected by central pain syndrome. Tricyclic antidepressants such as nortriptyline or anticonvulsants such as neurontin (gabapentin) can be useful, but also provide incomplete relief. Lowering stress levels appears to reduce pain.[6]

Prognosis

[edit]

Central pain syndrome is not a fatal disorder, but the syndrome causes disabling chronic pain and suffering among the majority of individuals who have it.[6]

See also

[edit]

References

[edit]
  1. ^ Watson, James; Sandroni, Paola (March 2016). "Central Neuropathic Pain Syndromes". Mayo Clinic Proceedings. 91 (3): 372–385. doi:10.1016/j.mayocp.2016.01.017. PMID 26944242.
  2. ^ "Central Pain Syndrome - Symptoms, Causes, Treatment | NORD". rarediseases.org. Archived from the original on 2018-03-10. Retrieved 2023-08-03.
  3. ^ Cheng, Jianguo; Ningegowda, Lokesh; Saeed, Pasha; Rosenquist, Rick (2013-02-01). "Central Pain Syndrome: Pathophysiology, Diagnosis, and Management, Second Edition". Anesthesiology. 118 (2): 472–473. doi:10.1097/ALN.0b013e31827d4197. ISSN 0003-3022.
  4. ^ Meacham, Kathleen; Shepherd, Andrew; Mohapatra, Durga; Haroutounian, Simon (April 21, 2017). "Neuropathic Pain: Central vs. Peripheral Mechanisms". Current Pain and Headache Reports. 21 (6): 28. doi:10.1007/s11916-017-0629-5. ISSN 1531-3433. PMID 28432601. S2CID 3342368.
  5. ^ Bowsher, David (1996), "Central pain: clinical and physiological characteristics", Journal of Neurology, Neurosurgery, and Psychiatry, vol. 61, no. 1, pp. 62–69, doi:10.1136/jnnp.61.1.62, PMC 486461, PMID 8676164 FREE full text. Requires 2 minute registration with BMJ.
  6. ^ a b c National Institute of Neurological Disorders and Stroke (13 January 2011). "NINDS Central Pain Syndrome Information Page". Ninds.nih.gov. NIH. Archived from the original on 9 February 2014. Retrieved 6 February 2014.
  7. ^ Ratini, Melinda (2 March 2013). "Pain Management: Central Pain Syndrome". WebMD. NIH. Retrieved 6 February 2014.
  8. ^ "Central Pain Syndrome - NORD (National Organization for Rare Disorders)". NORD (National Organization for Rare Disorders). Archived from the original on 2018-03-10. Retrieved 2017-06-08.

Further reading

[edit]

Canavero S, & Bonicalzi V (2007) Central pain syndrome. New York: Cambridge university press (1st ed) ISBN 0-521-86692-8 (2011) new edition

[edit]
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