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Central pain: an overview.
Jacques Devulder1, Erwin Crombez, Eric Mortier
1Department of Anaesthesia-section Pain Clinic, Ghent University Hospital, Ghent, Belgium. jacques.devulder@rug.ac.be
Acta Neurologica Belgica
|October 29, 2002
Summary
Central pain, a neuropathic pain type, arises from spinothalamocortical pathway lesions. Treatment involves medications like amitriptyline and sodium channel blockers, with advanced options including invasive electrostimulation for severe cases.
Area of Science:
- Neuroscience
- Pain Medicine
- Neurology
Background:
- Central pain is a neuropathic pain type resulting from spinothalamocortical pathway lesions.
- Ectopic neuronal discharges in the spinal cord and brain characterize this condition.
- Patients often report burning or ice-like sensations, more common with spinal cord injuries.
Purpose of the Study:
- To review the mechanisms and treatment strategies for central pain.
- To highlight the role of neurotransmitters in pain transmission.
- To discuss pharmacological and invasive treatment options.
Main Methods:
- Review of literature on central pain mechanisms and treatments.
- Discussion of neuroimaging techniques like functional MRI and PET.
- Analysis of pharmacological interventions and electrostimulation therapies.
Main Results:
- Spinothalamocortical lesions lead to ectopic neuronal discharges causing central pain.
- Neurotransmitters such as glutamate and glycine play a role in pain transmission.
- First-line treatments include amitriptyline and sodium channel blockers; advanced options involve intrathecal administration and electrostimulation.
Conclusions:
- Central pain management requires a multi-faceted approach, from medication to invasive procedures.
- Understanding neurotransmitter roles aids in developing targeted therapies.
- Intrathecal drug delivery and neuromodulation offer alternatives when conventional treatments fail.