Purpose of Review

Post-stroke pain represents a complex condition with few standardized diagnostic criteria. As such, the array of symptoms is often difficult to categorize and diagnose. Central post-stroke pain (CPSP), also known as Dejerine–Roussy syndrome, presents as painful paresthesia in any part of the body that is usually coupled with sensory abnormalities.

Recent Findings

In patients who had experienced a cerebrovascular accident, CPSP typically affects the same areas of the body that are also impacted by the general motor and sensory deficits that result from stroke. Though it is generally debated, CPSP is thought to result from a lesion in any part of the central nervous system. Pain usually presents in the range of 3–6 months after the occurrence of stroke, manifesting contralaterally to the lesion, and most commonly involving the upper extremities. For the most accurate diagnosis of CPSP, a thorough history and clinical examination should be supplemented with imaging. Infarcted areas of the brain can be visualized using either CT or MRI. First-line treatment of CPSP is pharmacologic and consists of a three-drug regimen. Despite this, CPSP is often refractory to medical management producing only modest pain reduction in a limited subset of patients. Adverse effects associated with pharmacologic management of CPSP and frequent recalcitrance to treatment have driven alternative minimally invasive methods of pain control which include transcranial stimulation, deep brain stimulation, and neuromodulation.

Summary

The aim of this review is to provide a comprehensive update to recent advances in the understanding of the treatment and management of CPSP.

中文翻译：

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Dejerine-Roussy综合征的诊断，治疗和管理：全面综述。

审查目的

中风后疼痛代表了一种复杂的疾病，几乎没有标准化的诊断标准。因此，通常很难对症状进行分类和诊断。中风后中枢疼痛（CPSP），也称为Dejerine-Roussy综合征，表现为身体任何部位的疼痛感觉异常，通常伴有感觉异常。

最近的发现

在经历过脑血管意外的患者中，CPSP通常会影响到身体的相同区域，这些区域也会受到中风导致的一般运动和感觉缺陷的影响。尽管人们普遍争论，CPSP被认为是中枢神经系统任何部位的病变所致。疼痛通常在中风发生后的3–6个月内出现，表现在病变的对侧，并且最常见于上肢。为了对CPSP进行最准确的诊断，应结合影像学和全面的病史和临​​床检查。可以使用CT或MRI可视化大脑梗塞区域。CPSP的一线治疗是药理性的，由三药疗法组成。尽管如此，CPSP通常对医疗管理无能为力，只能在有限的一部分患者中适度减轻疼痛。与CPSP的药理学管理有关的不良反应以及对治疗的频繁顽固性驱使人们选择了其他的微创疼痛控制方法，包括经颅刺激，深部脑刺激和神经调节。

概要

此次审查的目的是全面了解CPSP的治疗和管理方面的最新进展。