Central Pain Syndrome

Description:

This book sheds new light on central pain, a field that is largely obscured by lack of knowledge among pain professionals at all levels, including high-end pain centers. As a matter of fact, central pain, classified as a form of neuropathic pain, remains too often a scourge for those affected due to the ignorance of pain therapists worldwide and enduring misconceptions at the academic level. By weighing up the relevant evidence, the authors aim to remedy the situation by providing clear-cut, no-nonsense, unbiased and directly applicable clinical information. The clinically sound guidelines presented here are based on the authors’ twenty years of treating patients and conducting research in the field. The book will be an invaluable guide for neurologists, neurosurgeons, anesthesiologists, pain therapists as well as physiotherapists.

Table of Contents:

Part I: Clinical Features

1: Introduction

References

2: Epidemiology

2.1 Brain Central Pain (BCP)

2.2 Cord Central Pain (CCP) (a.k.a. Below-Level Pain, Remote Pain)

2.3 Central Pain in Specific Conditions

References

3: Clinical Features

3.1 Lesions Associated with CP (Tables 3.1 and 3.2)

3.2 Location of Lesions Causing CP

3.3 Pain Onset (Table 3.4)

3.4 Side of the Lesions (Table 3.5)

3.5 Pain Distribution

3.6 Quality of Pain

3.7 Intensity of Pain

3.8 Components

3.9 Evoked Pains

3.10 Other Signs and Symptoms of Interest

3.11 Multiple Sclerosis (MS) (Table 3.9)

3.12 Neuromyelitis Optica (NMO) (Table 3.10)

3.13 Others

References

4: Somatosensory Findings

References

5: Central Pruritus

References

6: Central Pain-Allied Conditions (CPAC)

6.1 CPAC 1: Painful Somatosensory Seizures

6.2 CPAC 2: Parkinson’s Disease (PD), Dystonia, and Corticobasal Syndrome (Table 6.1)

6.3 CPAC 3: Poststroke Shoulder Pain (PSSP) (Table 6.2)

6.4 CPAC 4: Creutzfeldt–Jakob Disease

6.5 CPAC 5: Dementia

6.6 CPAC 6: Chronic Hemibody Pain

6.7 CPAC 7: Burning Mouth Syndrome (BMS)

6.8 CPAC 8: Headache Associated with Pontine Infarction (Table 6.3)

References

7: Diagnosis

7.1 Recommended Diagnostic Approach

References

Part II: Genesis

8: Genesis

Appendix

Neurophysiological Studies

Commentary

Neuroimaging Studies

Commentary

References

Part III: Palliative Treatment

9: Placebo Modulation of Pain

References

10: Palliation: Introduction

References

11: GABA Agonists

References

12: Antiglutamatergic Agents

References

13: Channel Blockers

References

14: Brainstem Modulators

References

15: Gabapentinoids

References

16: Opioids and Antagonists

References

17: Cannabinoids

References

18: Sundry Molecules

References

19: Noninvasive Cortical Stimulation

19.1 Efficacy

19.2 Mechanism of Action

References

20: Invasive Cortical Stimulation

20.1 Efficacy (Table 20.1)

20.2 Adverse and Unusual Effects

20.3 Mechanism of Action (Boxes 20.1–20.3)

References

21: Deep Brain Stimulation

21.1 Efficacy (Table 21.1)

21.2 Mechanism of Action

21.2.1 PAG/PVG

21.2.2 Vc

21.2.3 ACC

21.2.4 Other Areas

21.3 Safety

References

22: Spinal Cord Stimulation

22.1 Efficacy (Table 22.1)

22.2 Mechanism of Action

22.3 SCS for PD-CPAC

References

23: Noninvasive Peripheral Nerve Stimulation

23.1 Mechanism of Action

23.2 Efficacy (Table 23.1–23.2)

References

24: Miscellaneous Neuromodulatory Techniques

References

25: Intraspinal Drug Infusion

References

26: Mind–Body Techniques

26.1 Psychotherapy

26.2 Neurofeedback

26.3 Bodily Illusions

26.4 Mental Imagery

26.5 Virtual Reality Distraction Pain Therapy (VRDPT)

26.6 Mindfulness Meditation (MM)

26.7 Hypnosis

References

27: Complementary Physical Therapies

References

28: Complementary Drug Therapy

References

29: Acupuncture and Reflexology

References

30: Palliative Therapy: Guidelines

Part IV: Curative Treatment

31: Curative Surgery and Other Experimental Approaches

31.1 Invasive Ablation

31.2 Noninvasive Ablation

31.3 Other Experimental Surgical Approaches

31.4 Reconstructive Neurosurgery

References