Central pain syndrome is a neurological condition consisting of constant, moderate to severe pain due to damage to the

central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...

(CNS) which causes a

sensitization Sensitization is a non-associative learning process in which repeated administration of a stimulus results in the progressive amplification of a response. Sensitization often is characterized by an enhancement of response to a whole class of sti ...

of the pain system. The extent of pain and the areas affected are related to the cause of the injury.

Signs and symptoms

Pain can either be relegated to a specific part of the body or spread to the entire body. It is typically constant, and may be moderate to severe in intensity. Those who are afflicted describe it as being stuck in a loop of pain. It is often made worse by touch, movement, emotions, barometric pressure and temperature changes, usually cold temperatures along with many other similar 'triggers'. Cold temperatures regularly make the burning pain worse in certain body parts. Burning pain is the most common sensation, but patients also report pins and needles, pressing, lacerating, aching, and extreme bursts or constant sharp or unremitting excruciating pain. Individuals may have reduced sensitivity to touch in the areas affected by the pain, as if the part is 'falling asleep'. The burning and loss of

sense of touch In physiology, the somatosensory system is the network of neural structures in the brain and body that produce the perception of touch ( haptic perception), as well as temperature ( thermoception), body position (proprioception), and pain. It ...

are usually, but not always, most severe on the distant parts of the body, such as the feet or hands, spreading until it is in some cases felt from head to toe. Usually the burning pain in body parts is a result of old injuries that seem like they should have healed long ago, yet the pain lingers on and even years afterwards. For some patients with intense affliction, there often can be unremitting

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...

, causing

vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteri ...

. The pain can also bring on hyperventilation. Blood pressure can rise due to the pain.

Cause

Damage to the CNS can be caused by car accidents, limb

amputations Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on ind ...

trauma Trauma most often refers to: * Major trauma, in physical medicine, severe physical injury caused by an external source * Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic i ...

spinal cord injury A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cor ...

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

s, stroke, immune system disorders or diseases, such as multiple sclerosis,

Parkinson's Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms becom ...

Graves A grave is a location where a dead body (typically that of a human, although sometimes that of an animal) is buried or interred after a funeral. Graves are usually located in special areas set aside for the purpose of burial, such as grave ...

Addison's disease Addison's disease, also known as primary adrenal insufficiency, is a rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adre ...

rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are invol ...

, and

epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrica ...

. It may develop months or years after injury or damage to the CNS.

Diagnosis

A diagnosis of central pain syndrome is based upon identification of characteristic symptoms, a detailed patient history, a thorough clinical evaluation and a variety of specialized tests. Central pain syndrome is suspected in individuals who complain of pain or other abnormal sensations following injury to the central nervous system. Other conditions that cause pain may need to be excluded before a diagnosis of central pain syndrome is made.

Treatment

Pain medications often provide some reduction of pain, but not complete relief of pain, for those affected by central pain syndrome.

Tricyclic antidepressants Tricyclic antidepressants (TCAs) are a class of medications that are used primarily as antidepressants, which is important for the management of depression. They are second-line drugs next to SSRIs. TCAs were discovered in the early 1950s and wer ...

such as

nortriptyline Nortriptyline, sold under the brand name Pamelor, among others, is a medication used to treat depression. This medicine is used for: neuropathic pain, attention deficit hyperactivity disorder (ADHD), smoking cessation and anxiety. As with many a ...

or anticonvulsants such as

neurontin Gabapentin, sold under the brand name Neurontin among others, is an anticonvulsant medication primarily used to treat partial seizures and neuropathic pain. It is a first-line medication for the treatment of neuropathic pain caused by diabe ...

(gabapentin) can be useful, but also provide incomplete relief. Lowering stress levels appears to reduce pain. For regular treatment some people prefer body length heating pads while others rely on warm baths.

Prognosis

Central pain syndrome is not a fatal disorder, but the syndrome causes disabling

chronic pain Chronic pain is classified as pain that lasts longer than three to six months. In medicine, the distinction between acute and chronic pain is sometimes determined by the amount of time since onset. Two commonly used markers are pain that continue ...

and suffering among the majority of individuals who have it.

References

External links

USA National Institute of Neurological disorders and Stroke
- Authoritative 4 paragraphs on central pain. {{Authority control Chronic pain syndromes