Central Pain Syndrome


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Central Pain Syndrome (CPS)
Clinical Names


The Stroke Network
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Some oral antidepressants and anticonvulsants can be useful in treating mild central pain syndrome.  Older antidepressant drugs such as amitriptyline (Elavil) appear to reduce the pain, but they have side effects of sleepiness, dry mouth, and dizziness.  A newer antidepressant drug called duloxetine (Cymbalta) is also used for central pain syndrome; this drug has less of these undesirable side effects than amitriptyline.

Antiepileptic drugs (AEDs) appear to affect the transmission of the sensory nerves that result in central pain. The most commonly used AEDs for central pain syndrome are gabapentin (Neurontin) and pregabalin (Lyrica).  Other AEDs sometimes used in treatment of pain include carbamazepine (Tegretol) and topiramate (Topamax).

With time, pain may increase in intensity.  As pain eventually becomes worse, treatment may progress through increasingly strong analgesics and possibly up to narcotics.

Narcotics are the best drugs for pain because they bind specifically to pain receptors.  Narcotic analgesics like morphine, methadone and heroin are very effective. 

In cases where spasticity and stiffness are a contributor to pain, oral Baclofen may be prescribed.  High dosages of oral Baclofen may cause serious side-effects.  An implanted Interthecal Baclofen (ITB) Pump, which has virtually no side-effects, may become necessary. 

With an implanted pump, small amounts of the drug are delivered from the pump flowing to the fluid around the spinal cord.  Thus, only tiny amounts of drugs are affecting the central nervous system. 

Stroke Warning Signs

bullet Sudden numbness or weakness of the face, arm or leg, especially on one side of the body   
bullet Sudden confusion, trouble speaking or understanding   
bullet Sudden trouble seeing in one or both eyes   
bullet Sudden trouble walking, dizziness, loss of balance or coordination   
bullet Sudden, severe headache with no known cause


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