Central pain syndrome is a neurological condition caused by damage specifically to the central nervous system (CNS), brain, brainstem, or spinal cord. The pain is steady and is usually described as a burning, aching, or cutting sensation. Occasionally there may be brief, intolerable bursts of sharp pain. Central pain is characterized by a mixture of pain sensations, the most prominent being constant burning. Mingled with the burning are sensations of cold, "pins and needles" tingling, and nerve proximity (like that of a dental probe on an exposed nerve). The steady burning sensation is increased significantly by any light touch. Patients are somewhat numb in the areas affected by this burning pain. The burning and loss of touch appreciation are usually most severe on the distant parts of the body, such as the feet or hands. Pain may be moderate to severe in intensity and is often exacerbated by movement and temperature changes, usually cold temperatures. Central pain syndrome may develop months or even years after injury or damage to the CNS. The disorder occurs in patients who have, or have had, strokes, multiple sclerosis, limb amputations, or brain or spinal cord injuries.
Is there any treatment?
Pain medications often provide little or no relief for those affected by central pain syndrome. Tricyclic antidepressants, such as nortriptyline, or anticonvulsants such as gabapentin can be useful in this condition. Patients should be sedated and the nervous system should be kept quiet and as free from stress as possible.
What is the prognosis?
Central pain syndrome is not a fatal disorder. But for the majority of patients, the syndrome causes intractable pain and much suffering.
National Institute of Neurological Disorders and Stroke
Reviewed: May 2001
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