Central poststroke pain: somatosensory abnormalities and the presence of associated myofascial pain syndrome

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art_OLIVEIRA_Central_poststroke_pain_somatosensory_abnormalities_and_the_presence_2012_eng.PDF (1.35 MB)
Citações na Scopus
37
Tipo de produção
article
Data de publicação
2012
DOI
Scopus
Web of Science
PubMed
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ISSN da Revista
Título do Volume
Editora
BIOMED CENTRAL LTD
Autores
MACHADO, Andre Guelman Gomes
Citação
BMC NEUROLOGY, v.12, article ID 89, 8p, 2012
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Background: Central post-stroke pain (CPSP) is a neuropathic pain syndrome associated with somatosensory abnormalities due to central nervous system lesion following a cerebrovascular insult. Post-stroke pain (PSP) refers to a broader range of clinical conditions leading to pain after stroke, but not restricted to CPSP, including other types of pain such as myofascial pain syndrome (MPS), painful shoulder, lumbar and dorsal pain, complex regional pain syndrome, and spasticity-related pain. Despite its recognition as part of the general PSP diagnostic possibilities, the prevalence of MPS has never been characterized in patients with CPSP patients. We performed a cross-sectional standardized clinical and radiological evaluation of patients with definite CPSP in order to assess the presence of other non-neuropathic pain syndromes, and in particular, the role of myofascial pain syndrome in these patients. Methods: CPSP patients underwent a standardized sensory and motor neurological evaluation, and were classified according to stroke mechanism, neurological deficits, presence and profile of MPS. The Visual Analogic Scale (VAS), McGill Pain Questionnaire (MPQ), and Beck Depression Scale (BDS) were filled out by all participants. Results: Forty CPSP patients were included. Thirty-six (90.0%) had one single ischemic stroke. Pain presented during the first three months after stroke in 75.0%. Median pain intensity was 10 (5 to 10). There was no difference in pain intensity among the different lesion site groups. Neuropathic pain was continuous-ongoing in 34 (85.0%) patients and intermittent in the remainder. Burning was the most common descriptor (70%). Main aggravating factors were contact to cold (62.5%). Thermo-sensory abnormalities were universal. MPS was diagnosed in 27 (67.5%) patients and was more common in the supratentorial extra-thalamic group (P <0.001). No significant differences were observed among the different stroke location groups and pain questionnaires and scales scores. Importantly, CPSP patients with and without MPS did not differ in pain intensity (VAS), MPQ or BDS scores. Conclusions: The presence of MPS is not an exception after stroke and may present in association with CPSP as a common comorbid condition. Further studies are necessary to clarify the role of MPS in CPSP.
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URI
https://observatorio.fm.usp.br/handle/OPI/754
Referências
  1. ANDERSEN G, 1995, PAIN, V61, P187, DOI 10.1016/0304-3959(94)00144-4
  2. Beck AT, 1993, BECK DEPRESSION INVE
  3. BLUMER D, 1982, J NERV MENT DIS, V170, P381, DOI 10.1097/00005053-198207000-00001
  4. BOGOUSSLAVSKY J, 1988, NEUROLOGY, V38, P837
  5. BOIVIE J, 1991, SYMP PAIN R, P65
  6. BOWSHER D, 1993, LANCET, V341, P156, DOI 10.1016/0140-6736(93)90015-9
  7. Bowsher D, 1998, NEUROLOGY, V51, P1352
  8. Dejerine J, 1906, REV NEUROL-FRANCE, V14, P521
  9. Edinger L, 1891, DTSCH Z NERVENHEILK, V1, P262, DOI 10.1007/BF01796578
  10. Eisendrath SJ, 1995, NEUROLOGY, V45, pS26
  11. Gerwin R D, 2001, Curr Pain Headache Rep, V5, P412, DOI 10.1007/s11916-001-0052-8
  12. GONZALES GR, 1994, NEUROLOGY, V44, pA318
  13. Haanpaa M, 2010, PAIN
  14. Head H, 1911, BRAIN, V34, P102, DOI 10.1093/brain/34.2-3.102
  15. HERRMANN M, 1995, STROKE, V26, P850
  16. Hong JH, 2010, EUR NEUROL, V64, P163, DOI 10.1159/000319040
  17. Jensen MP, 1992, HDB PAIN ASSESSMENT, P135
  18. Klit H, 2009, LANCET NEUROL, V8, P857, DOI 10.1016/S1474-4422(09)70176-0
  19. Kuptniratsaikul V, 2009, AM J PHYS MED REHAB, V88, P92, DOI 10.1097/PHM.0b013e3181909d5f
  20. LEIJON G, 1989, PAIN, V36, P13, DOI 10.1016/0304-3959(89)90107-3
  21. Lin TY, 1997, PHYS MED REHABILITAT, V8, P207
  22. LOH L, 1981, BRIT MED J, V282, P1026
  23. MacGowan DJL, 1997, NEUROLOGY, V49, P120
  24. MELZACK R, 1975, PAIN, V1, P277, DOI 10.1016/0304-3959(75)90044-5
  25. MODAN B, 1992, STROKE, V23, P1230
  26. Pimenta CAM, 1994, DOR CONCEITOS GERAIS, P46
  27. Roosink M, 2011, J PAIN, V12, P476, DOI 10.1016/j.jpain.2010.10.009
  28. Schamahmann JD, 1992, ARCH NEUROL-CHICAGO, V49, P1032
  29. Staud R, 2009, PAIN, V145, P96, DOI 10.1016/j.pain.2009.05.020
  30. STEINBROCKER O, 1947, AM J MED, V3, P402, DOI 10.1016/0002-9343(47)90170-8
  31. Travell JG, 1983, MYOFASCIAL PAIN DYSF
  32. Treede RD, 2008, NEUROLOGY, V70, P1630, DOI 10.1212/01.wnl.0000282763.29778.59
  33. Treede RD, 2008, EUR J PAIN, V12, P395, DOI 10.1016/j.ejpain.2007.11.008
  34. Tuveson B, 2009, PAIN, V143, P84, DOI 10.1016/j.pain.2009.02.002
  35. VESTERGAARD K, 1995, PAIN, V61, P177, DOI 10.1016/0304-3959(94)00140-A
  36. Widar M, 2002, SCAND J CARING SCI, V16, P302, DOI 10.1046/j.1471-6712.2002.00090.x
  37. Widar M, 2002, J REHABIL MED, V34, P165, DOI 10.1080/16501970213237

Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/26