A Medication Combination for the Treatment of Central Post-Stroke Pain (CPSP) via the Adjuvant use of Prednisone with Gabapentin: A Case Report

Publication date: Available online 25 September 2015 Source:PM&R Author(s): Luis Batlle, Ryan Mattie, Robert Irwin Case Description CPSP is a neuropathic pain syndrome that can occur from pathology of the brain. The case presented is of a female with multiple comorbidities and who was found to have an acute infarct in the left middle and anterior cerebral artery territories. She began to complain of worsening diffuse right upper and lower extremity pain, and central post-stroke pain was diagnosed. First-line agents were contraindicated due to medical comorbidities, and chronic kidney disease only permitted the use of low dose gabapentin. The patient’s morbid obesity inspired the use of an adjunct medication protocol of a prednisone taper for proper treatment. After starting this treatment regimen, the patient experienced significant pain relief with eventual resolution. A steroid-based treatment protocol was successfully utilized in the early stages of central post-stroke pain with proper side effect management, and may have prevented difficult treatment management in the outpatient setting.
Source: PMandR - Category: Rehabilitation Source Type: research