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Central pain: clinical and physiological characteristics

D Bowsher1

  • 1Pain Research Institute, Walton Hospital, Liverpool, UK.

Journal of Neurology, Neurosurgery, and Psychiatry
|July 1, 1996
PubMed
Summary

Central pain following central nervous system (CNS) damage often presents with delayed onset and autonomic instability. Findings suggest receptor dysregulation, possibly noradrenergic, may underlie this chronic pain condition.

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Area of Science:

  • Neuroscience
  • Pain Medicine
  • Neurology

Background:

  • Central pain arises from damage to the central nervous system (CNS).
  • Understanding its clinical and pathophysiological features is crucial for effective management.

Purpose of the Study:

  • To investigate the clinical and pathophysiological characteristics of central pain in patients with CNS damage.
  • To explore sensory perception thresholds and autonomic function in relation to central pain.

Main Methods:

  • Clinical investigation of 156 patients with central pain, including those with ischemic strokes and spinal cord pathology.
  • Quantitative sensory testing of perception thresholds and assessment of autonomic function were performed.

Main Results:

  • Delayed pain onset (weeks to years) was common (>60%).
  • Allodynia, including movement allodynia, was prevalent (two-thirds of patients).
  • Autonomic instability, with pain exacerbated by stress and alleviated by relaxation, was observed. Sensory deficits, particularly for thermal and pinprick stimuli, correlated with pain severity.

Conclusions:

  • The findings support a pathogenetic hypothesis involving the upregulation or downregulation of neurotransmitter receptors over time.
  • Noradrenergic pathways are implicated as a potential key mechanism in the development and maintenance of central pain.

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