Almost all pain develops within the periphery following distress, damage or sickness to a body part, however, in many unusual cases pain is created in the brain in contrast to the usual set up. During these exceptional circumstances though the body part might have recovered from its initial physical harm, yet the brain will keep feeling the distress.
Such a condition is referred to as Central Pain Syndrome because of its origin in the central nervous system or the brain. A good example of this syndrome is the Phantom limb pain which is a bizarre sickness that sometimes arises following the amputation of a limb of the patient.
Thus central pain syndrome begins in the brain (not in the peripheral nerves) ;in other words, it is a neurological status caused by a malfunction of the central nervous system e.g. some grievance to the sensory trails within the brain kindle the fibers of the central nerves and in this manner create an awareness of pain.
This complaint usually happens within the thalamus——- a system that transmits sensory information (except that of smell) to other parts of the brain. The common types of such grievances are
o Bleeding (hemorrhage)
o Ischemic stroke( when an artery to the brain is obstructed)
o Parkinson’s disease
o Brain growth
o Harm to the brain
o Damage to the Spinal cord
o Removal of the limb
o Multiple Sclerosis—–a malady in which the system of bodily resistance assaults the defensive sheath that covers the nerves.
The Central Pain Syndrome may arise months or years after impairment to the Central nervous system.The thalamus comprises two joined lobes. When one fraction of the thalamus is offended, the opposed side of the body is deficient in feeling. In the beginning, this may entail a whole failure of sensation. When sensation comes back, it is hazy and vague. Patients pronounce that they feel a smoldering pain, prickly pins and needles, or an irritation that transforms towards hurting. The pain itself can vary from a minor irritation to powerful, incapacitating and hindering.
Symptoms of Central Pain Syndrome:
- Constant burning sensation which, at times amplifies by gentle touch
Pain is classically steady and may be modest to ruthless in concentration; it is frequently made shoddier by laying a hand on, movement, sentiments and alterations in temperature. Patients are liable to experience one or more styles of pain sensations, the most outstanding being that of smoldering sort. Blended with the smoldering pain the patient may endure undesirable tingling and prickly pains. Many a times, the patients experience short, unbearable spurts of prickly pain comparable to the pain instigated by a dental probe on an uncovered nerve.
Often in central pain syndromes, the constituent of the nervous system that is accountable for transportation of cold sensations to the brain is smashed. This frequently happens as a result of injury to the tracts of nerves that convey cold sensations in the spinal-cord or superior areas of this alleyway positioned in the brain. As a result, the brain is powerless to feel the sensation of cold; in its place, it senses pain as a substitute.
Treatment of Central Pain Syndrome:
- Though common pain killer medicines are used during the initial stages, yet they do not prove very helpful
- Some anticonvulsants
- Antiepileptic drugs such as Gabapentin, Pregabalin, Carbamazepine and Topiramate etc Though these drugs do decrease the strength of pain ,yet they are not restorative.
- Antidepressants: A newer antidepressant known as Duloxetine (Cymbalta)is being used currently because unlike the tricyclic antidepressant amitriptyline,it has fewer unwanted side effects.
The idea is to tranquilize the patient so that his or her nervous system is kept calm and as anxiety-free as possible.
- Narcotic analgesics such as morphine, heroin, and methadone serve as the best pain killers on account of the fact that they bind to pain receptors distinctively
These could be administered in the form of an implantable pump.
- Neurosurgery is the definite last way out.
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