Does Post-Stroke Pain Really Go Away? First described by Dejerine and Roussy in 1906 when they coined the term “syndrome thalaminque” or thalamic syndrome. CPSP is an increased noxious response to normal or subthreshold stimulation. When the brain processes ANY stimulation it is typically perceived as painful. What a torturous experience! For years, it was believed that the the intolerable pain on the hemiplegic side were due to strokes to the thalamus. However, more recent studies have shown that the thalamus is only one of the many sites that may be affected by CPSP. CPSP can be found in any of the tracts responsible for transmission of pain throughout the CNS. (Treister, 2017) ??Spinothalamic ??Medullary ??Cerebral cortex Many people describe it as a burning or cold sensation or a throbbing or shooting pain. CPSP may effect up to 8% of stroke patients. (Kalichman and Ratmansky, 2011) While the exact pathogenesis of CPSP is currently unknown, it is suggested that underlying causes include hyperexcitation in the damaged sensory pathways, damage to the central inhibitory pathways, or a combination of both. The area most responsible is some portion of the central pain pathway. The affected area creates the sensation of pain with minimal or no stimulation of the peripheral pain receptors. Treatment options such as surgery, deep brain stimulation and medications are extremely limited with less than favorable outcomes. If you have seen good results treating CPSP, please do share so we can help our patients improve and rid themselves from this dreadful condition. #noplateauinsight
