An East-West Approach to the Management of Central Post-Stroke PainYen H.L. · Chan W.
Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
The development of neuropathic pain following stroke is not uncommon. The consequences include significant disabilities and depression. Treatment can often be difficult and responses unsatisfactory. We report a patient with severe central post-stroke pain (CPSP) of the right leg benefiting from a combination of Western multidisciplinary therapies and acupuncture. A literature search has revealed that relatively few studies have been done on the management of CPSP, compared with other types of neuropathic pain. Amitriptyline and carbamazepine were found to produce positive effects on post-stroke pain in one small study; lamotrigine and gabapentin are two newer drugs which appear promising. To the best of our knowledge, the use of acupuncture for the treatment of CPSP has not been previously reported.
© 2003 S. Karger AG, Basel
Dejerine J, Roussy G: Le syndrome thalamique. Rev Neurol 1906;14:521–532.
- Jensen TS, Lenz FA: Central post-stroke pain: A challenge for the scientist and the clinician. Pain 1995;61:161–164.
- Andersen G, Vestergaard K, Ingeman-Nielsen M, Jensen TS: Incidence of central post-stoke pain. Pain 1995;61:187–193.
- Bowsher D: The management of central post-stroke pain. Postgrad Med J 1995;71:598–604.
- Bowsher D: Central pain: Clinical and physiological characteristics. J Neurol Neurosurg Psychiatry 1996;61:62–69.
- Smith TE, Chong MS: Neuropathic pain. Hosp Med 2000;61:760–766.
- Sindrup SH, Jensen TS: Efficacy of pharmacological treatments of neuropathic pain: An update and effect related to mechanism of drug action. Pain 1999;83:389–400.
- Leijon G, Boivie J: Central post-stroke pain – A controlled trial of amitriptyline and carbamazepine. Pain 1989;36:27–36.
- Vestergaard K, Andersen G, Gottrup H, Kristensen BT, Jensen TS: Lamotrigine for central poststroke pain: A randomized controlled trial. Neurology 2001;56:184–190.
- Nicholson B: Gabapentin use in neuropathic pain syndromes. Acta Neurol Scand 2000;101:359–371.
- Lee TL: Acupuncture and chronic pain management. Ann Acad Med Singapore 2000;29:17–21.
- Hammerschlag R: Methodological and ethical issues in clinical trials of acupuncture. J Altern Complement Med 1998;4:159–171.
- Acupuncture. NIH Consensus Conference. JAMA 1998;280:1518–1524.
- Melzack R, Wall PD: Pain mechanisms: A new theory. Science 1965;150:971–979.
Bowsher D: Mechanisms of acupuncture; in Filshie J, White A (eds): Medical Acupuncture: A Western Scientific Approach. London, Churchill Livingstone 1998, pp 69–82.
- Pomeranz B: Basic research into acupuncture for the relief of pain. J Altern Complement Med 1996;2:53–59.
Han JS, Terenius L: Neurochemical basis of acupuncture analgesia. Ann Rev Pharmacol Toxicol 1982;22:193–220.
- Hui KK, Liu J, Makris N, Gollub RL, Chen AJ, Moore CI, Kennedy DN, Rosen BR, Kwong KK: Acupuncture modulates the limbic system and subcortical gray structures of the human brain: Evidence from fMRI studies in normal subjects. Hum Brain Mapp 2000;9:13–25.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.