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Pharmacotherapy to Manage Central Post-Stroke Pain
AbstractCentral post-stroke pain is a chronic neuropathic pain syndrome following a cerebrovascular accident. The development of central post-stroke pain is estimated to occur in 8 to 55% of stroke patients and is described as constant or intermittent neuropathic pain accompanied by dysesthesia of temperature and/or pressure sensations. These pain and sensory deficits are within the area of the body corresponding to the stroke lesion. The onset of pain is usually gradual, though it can develop either immediately after stroke or years after. Given the diversity in its clinical presentation, central post-stroke pain is a cha...
Source: CNS Drugs - February 7, 2021 Category: Neurology Source Type: research

Pharmacological Management of Central Post-Stroke Pain: A Practical Guide
Abstract Pain is one of the most troublesome sequelae of stroke. Some of this post-stroke pain is caused by the brain lesion itself; this is called central post-stroke pain (CPSP). Although the prevalence of CPSP is low (1–8 %), persistent, often treatment-resistant, painful sensations are a major problem for stroke patients. The pathogenesis of CPSP remains unknown, but suggested underlying causes include hyperexcitation in the damaged sensory pathways, damage to the central inhibitory pathways, or a combination of the two. For pharmacological treatment, amitriptyline, an adrenergic antidepressant, is current...
Source: CNS Drugs - September 1, 2014 Category: Neurology Source Type: research

Post-stroke shoulder pain: Nociceptive or neuropathic?
Acute rehabilitation after stroke can be adversely affected by complications such as pain in the hemiplegic shoulder. The onset of hemiplegic shoulder pain (HSP) can compromise functional gains, and has been shown to contribute to longer term disability . The first systematic study of the incidence of post-stroke shoulder pain (PSSP) found that 40% of patients were affected during the 3–6months following survival of a stroke . In 25% of patients, pain occurred during the first two weeks after stroke . The prognosis at six months, however, appears to be reasonably good, with 80% of patients reporting improvement or comple...
Source: Pain - November 26, 2012 Category: Anesthesiology Authors: Anthony K.P. Jones, Christopher A. Brown Tags: Commentaries Source Type: research

Although pharmacological treatment may have beneficial effects in central post-stroke pain, it does not abolish the symptoms
Abstract The management of central post-stroke pain is challenging. Amitriptyline is considered the first-line pharmacological choice, with lamotrigine, gabapentin and pregabalin used as alternative therapies. If the therapeutic response with monotherapy is insufficient, combination therapy (e.g. an adrenergic antidepressant plus an antiepileptic) may be considered.
Source: Drugs and Therapy Perspectives - February 4, 2015 Category: Drugs & Pharmacology Source Type: research

E-135 Dejerine-roussy syndrome in the setting of right sigmoid sinus thrombosis: a unique case report
DiscussionThis case illustrates the important clinical aspects and physical findings needed to diagnose DRS. The presence of focal allodynia and hyperalgesia with recent cerebrovascular incidents provides significant evidence for DRS. The purpose of this case is to provide awareness and to increase clinical suspicion of DRS during examination, especially in the setting of cerebral venous sinus occlusion as infarction alone may not present as atypical allodynia.Disclosures S. Nittala: None. C. Jara: None. D. Raza: None. J. Cazzaniga: None. D. Filippi: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Nittala, S., Jara, C., Raza, D., Cazzaniga, J., Filippi, D. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Childhood and Adolescent Migraine Prevention (CHAMP) Study: A Double‐Blinded, Placebo‐Controlled, Comparative Effectiveness Study of Amitriptyline, Topiramate, and Placebo in the Prevention of Childhood and Adolescent Migraine
ConclusionsThe goal of the CHAMP study is to obtain level 1 evidence for the effectiveness of amitriptyline and topiramate in the prevention of migraine in children and adolescents. If this study proves to be positive, it will provide information to the practicing physician as how to best prevent migraine in children and adolescents and subsequently improve the disability and outcomes.
Source: Headache: The Journal of Head and Face Pain - April 17, 2013 Category: Neurology Authors: Andrew D. Hershey, Scott W. Powers, Christopher S. Coffey, Dixie D. Eklund, Leigh Ann Chamberlin, Leslie L. Korbee, Tags: Protocols Source Type: research

Top 20 Research Studies of 2022 for Primary Care Physicians
This article summarizes the top 20 research studies of 2022 identified as POEMs (patient-oriented evidence that matters), excluding COVID-19. Statins for primary prevention of cardiovascular disease produce only a small absolute reduction in a person's likelihood of dying (0.6%), having a myocardial infarction (0.7%), or having a stroke (0.3%) over three to six years. Supplemental vitamin D does not reduce the risk of a fragility fracture, even in people with low baseline vitamin D levels or a previous fracture. Selective serotonin reuptake inhibitors are preferred medical therapy for panic disorder, and patients who disco...
Source: American Family Physician - April 13, 2023 Category: Primary Care Authors: Roland Grad Mark H Ebell Source Type: research

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