ABSTRACT
Central poststroke pain (CPSP) was originally thought to be “thalamic” pain, as described by Dejerine and Roussy, although it was described even earlier in 1883. Dejerine and Roussy characterized their eponymous thalamic pain syndrome as including hemiplegia; hemiataxia and hemiastereognosis; difficulties with both superficial and deep sensation; persistent, paroxysmal, typically intolerable pain; and choreoathetoid movements. CPSP is broadly defined as central neuropathic pain, secondary to lesions or dysfunction in the central nervous system. It is typically characterized by constant or intermittent pain and sensory abnormalities, most commonly of thermal sensation. Locations of the lesions inducing the CPSP have been demonstrated to be referable to the spinothalamocortical tract/pathway, typically associated with abnormal evoked sensations in the peripherally affected area. Amitriptyline is thought to be helpful, secondary to its reuptake inhibition of serotonin and norepinephrine. One undesirable effect of repetitive deep brain stimulation is the reduction of the seizure threshold, known as kindling.
