Frequency and features of the central poststroke pain

Abstract

Background: Central poststroke pain (CPSP) is often unrecognized in clinical practice, it may aggravate the rehabilitation process and reduce quality of life. Aim: To determine the frequency and features of CPSP, as well as to make possible associations of CPSP with sociodemographic and clinical features of subjects with stroke. Method: In a two-year period 602 patients with previous stroke were consecutively tested. We used three questionnaires for the diagnosis of neuropathic pain (Pain Detect Questionnaire - PD-Q, The Leeds Assessment of Neuropathic Symptoms and Signs - LANSS and Douleur neuropatathique en 4 questions - DN4). Results: CPSP was present in 12% of our patients with stroke, and usually occurred in the first several months after stroke. It was associated with cortical and thalamic localization of stroke, higher level of functional disability, as well as with younger age. The most important features that distinguish CPSP from other types of pain were presence of allodynia and pricking hypoesthesia, while other neuropathic sensations were common in stroke subjects both with and without CPSP. Conclusion: Younger subjects with cortical/thalamic stroke and higher level of disability should be thoroughly examined for the presence of neuropatic pain, since this may highly influence therapeutic strategy and quality of life in these subjects. © 2018 Elsevier B.V.