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• W2146648139 abstract "Central pain with dissociated thermoalgesic sensory loss is common in spinal and brainstem syndromes but not in cortical lesions. Out of a series of 270 patients investigated because of somatosensory abnormalities, we identified five subjects presenting with central pain and pure thermoalgesic sensory loss contralateral to cortical stroke. All of the patients had involvement of the posterior insula and inner parietal operculum. Lemniscal sensory modalities (position sense, graphaestesia, stereognosis) and somatosensory evoked potentials to non-noxious inputs were always preserved, while thermal and pain sensations were profoundly altered, and laser-evoked potentials to thermo-nocoiceptive stimuli were always abnormal. Central pain resulting from posterior parasylvian lesions appears to be a distinct entity that can be identified unambiguously on the basis of clinical, radiological and electrophysiological data. It presents with predominant or isolated deficits for pain and temperature sensations, and is paradoxically closer to pain syndromes from brainstem lesions affecting selectively the spinothalamic pathways than to those caused by focal lesions of the posterior thalamus. The term ‘pseudo-thalamic’ is therefore inappropriate to describe it, and we propose parasylvian or operculo-insular pain as appropriate labels. Parasylvian pain may be extremely difficult to treat; the magnitude of pain-temperature sensory disturbances may be prognostic for its development, hence the importance of early sensory assessment with quantitative methods." @default.
• W2146648139 created "2016-06-24" @default.
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• W2146648139 date "2010-08-18" @default.
• W2146648139 modified "2023-10-14" @default.
• W2146648139 title "Operculo-insular pain (parasylvian pain): a distinct central pain syndrome" @default.
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• W2146648139 doi "https://doi.org/10.1093/brain/awq220" @default.
• W2146648139 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/20724291" @default.
• W2146648139 hasPublicationYear "2010" @default.
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