Central poststroke pain: somatosensory abnormalities and the presence of associated myofascial pain syndrome


Autoria(s): Oliveira, Rogerio Adas Ayres de; Andrade, Daniel Ciampi Araujo de; Machado, Andre Guelman Gomes; Teixeira, Manoel Jacobsen
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

06/11/2013

06/11/2013

11/09/2012

Resumo

Background: Central post-stroke pain (CPSP) is a neuropathic pain syndrome associated with somatosensory abnormalities due to central nervous system lesion following a cerebrovascular insult. Post-stroke pain (PSP) refers to a broader range of clinical conditions leading to pain after stroke, but not restricted to CPSP, including other types of pain such as myofascial pain syndrome (MPS), painful shoulder, lumbar and dorsal pain, complex regional pain syndrome, and spasticity-related pain. Despite its recognition as part of the general PSP diagnostic possibilities, the prevalence of MPS has never been characterized in patients with CPSP patients. We performed a cross-sectional standardized clinical and radiological evaluation of patients with definite CPSP in order to assess the presence of other non-neuropathic pain syndromes, and in particular, the role of myofascial pain syndrome in these patients. Methods: CPSP patients underwent a standardized sensory and motor neurological evaluation, and were classified according to stroke mechanism, neurological deficits, presence and profile of MPS. The Visual Analogic Scale (VAS), McGill Pain Questionnaire (MPQ), and Beck Depression Scale (BDS) were filled out by all participants. Results: Forty CPSP patients were included. Thirty-six (90.0%) had one single ischemic stroke. Pain presented during the first three months after stroke in 75.0%. Median pain intensity was 10 (5 to 10). There was no difference in pain intensity among the different lesion site groups. Neuropathic pain was continuous-ongoing in 34 (85.0%) patients and intermittent in the remainder. Burning was the most common descriptor (70%). Main aggravating factors were contact to cold (62.5%). Thermo-sensory abnormalities were universal. MPS was diagnosed in 27 (67.5%) patients and was more common in the supratentorial extra-thalamic group (P <0.001). No significant differences were observed among the different stroke location groups and pain questionnaires and scales scores. Importantly, CPSP patients with and without MPS did not differ in pain intensity (VAS), MPQ or BDS scores. Conclusions: The presence of MPS is not an exception after stroke and may present in association with CPSP as a common comorbid condition. Further studies are necessary to clarify the role of MPS in CPSP.

Department of Neurology, University of São Paulo, Brazil

Identificador

BMC NEUROLOGY, v.12, SEP 11, 2012

1471-2377

http://www.producao.usp.br/handle/BDPI/42595

10.1186/1471-2377-12-89

http://dx.doi.org/10.1186/1471-2377-12-89

Idioma(s)

eng

Publicador

BIOMED CENTRAL LTD

Relação

BMC NEUROLOGY

Direitos

openAccess

Copyright BIOMED CENTRAL LTD

Palavras-Chave #LONG-TERM PAIN #SENSORY ABNORMALITIES #STROKE #DISEASE #LESIONS #SYSTEM #CLINICAL NEUROLOGY
Tipo

article

original article

publishedVersion