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  STROKE: NEW IDEAS, PERSISTING DILEMMAS 

Panminerva Medica 2013 March;55(1):1-10

Copyright © 2013 EDIZIONI MINERVA MEDICA

lingua: Inglese

The complexities of pain after stroke - A review with a focus on central post-stroke pain

Seifert C. L. 1, 4, Mallar Chakravarty M. 5, 6, Sprenger T. 2, 3

1 Department of Neurology, Technische Universität München, Munich, Germany; 2 Department of Neurology, University Hospital Basel, Basel, Switzerland; 3 Division of Neuroradiology, University Hospital Basel, Basel, Switzerland; 4 Department of Psychiatry, University of Basel, Basel, Switzerland; 5 Kimel Family Translational Imaging Genetics Laboratory, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada; 6 Department of Psychiatry and Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada


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Pain is frequently reported following stroke, but seems to be an underemphasized phenomenon since it can importantly impact rehabilitation and long-term outcomes. Two major forms of pain have to be distinguished in patients with post-stroke pain: central, neuropathic pain, arising from the vascular lesion defined as central post-stroke pain (CPSP) and pain primarily triggered by peripheral mechanisms such as hemiplegic shoulder pain and spasticity-related pain. Headache after stroke is difficult to classify since the pathophysiology is unclear. The suggested underlying mechanisms as well as treatment strategies of post-stroke pain differ according to the origin (peripheral versus central). This article aims at reviewing the pertinent evidence regarding clinical characteristics and mechanisms of post-stroke pain generation with a focus on CPSP. We discuss possible treatment options and highlight current pathophysiological concepts.

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