Central Pain Syndrome: Pathophysiology, diagnosis and management

COVER......Page 1
HALF-TITLE......Page 3
TITLE......Page 5
COPYRIGHT......Page 6
DEDICATION......Page 7
CONTENTS......Page 9
LIST OF TABLES......Page 13
PREFACE (OR, THE STORY OF AN IDEA)......Page 15
DEFINITIONS......Page 17
HISTORY......Page 19
1. Lesions causing CP and location (Table 2.1a,b)......Page 25
2. Incidence and prevalence (Table 2.2)......Page 38
5. Time to pain onset (Table 2.5)......Page 44
8. Pain distribution......Page 56
9. Quality of pain (Table 2.8)......Page 63
11. Components......Page 65
12. Evoked pains......Page 70
13. Somatosensory findings (Tables 2.10–2.12)......Page 72
14. Sympathetic and other signs and symptoms......Page 115
1. Sensory epilepsy......Page 116
2. Parkinson’s disease (PD)......Page 117
3. Iatrogenic lesions (Table 2.13)......Page 118
2. Incidence and prevalence (Table 3.4)......Page 129
4. Time to pain onset......Page 132
5. Level of lesion......Page 133
6. Distribution of pain......Page 134
7. Quality......Page 135
10. Evoked pains......Page 136
11. Somatosensory deficits (Table 3.6)......Page 137
13. Course......Page 144
1. Syringomyelia......Page 145
2. Multiple sclerosis (MS)......Page 146
3. Spinal epilepsy......Page 148
4 DIAGNOSING CENTRAL PAIN......Page 149
5 DRUG THERAPY......Page 154
1. General comments......Page 155
2. Drug aggravation of CP......Page 198
ELECTRICAL......Page 199
1. Extra- and subdural motor (MCS) and sensory cortex stimulation (PCS) (Table 6.1)......Page 200
Mechanism of action.......Page 215
3. Spinal cord stimulation (Table 6.3)......Page 227
4. Transcutaneous electrical nerve stimulation (TENS) (Table 6.4)......Page 234
7. Electroconvulsive therapy (Table 6.6)......Page 237
CHEMICAL (Table 6.7)......Page 239
ALTERNATIVE APPROACHES......Page 248
A FUTURE?......Page 251
7 PATHOPHYSIOLOGY: HUMAN DATA......Page 253
FUNCTIONAL IMAGING STUDIES......Page 255
1. Studies assessing the spontaneous resting component and its modulation......Page 256
2. Studies assessing the evoked components......Page 259
3. Studies assessing biochemical changes......Page 263
Findings in BCP......Page 270
Findings in CCP......Page 272
Findings in mixed series......Page 275
2. Evoked potentials studies......Page 281
Interpretation......Page 283
REPORTS OF SUDDEN DISAPPEARANCE OF CP......Page 316
8 PIECING TOGETHER THE EVIDENCE......Page 323
EXPLORING THE THEORETICAL FRAMEWORK......Page 326
TRIGGERING PERSISTENT OSCILLATION......Page 327
WHAT RELEASES CP?......Page 331
DISSECTING THE ROLE OF GABA......Page 337
WHICH ROLE FOR NEUROPLASTICITY?......Page 340
BILATERALITY OF CENTRAL PAIN......Page 343
LESSONS FROM CORD CENTRAL PAIN......Page 346
THE GENESIS OF ALLODYNIA......Page 352
REFERENCES......Page 355
INDEX......Page 395