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- W2323767068 abstract "Central Post Stroke Pain Syndrome (CPSP) is a neuropathic pain syndrome that can occur following a stroke. We present a 65 year old female with no previous pain complaints nor peripheral neuropathy, who developed intractable, unremitting dysesthesia described as burning pain in her left upper and lower extremities following a right basal ganglia hemmorragic stroke confirmed by neuroImaging. She was diagnosed with CPSP and all initial attempts to manage her pharmacologically and non-pharmacologically were suboptimal. A 3mm skin biopsy of her left lower extremity was performed to evaluate for possible peripheral nervous system dysfunction. Results demonstrated reduced epidermal nerve fiber density, consistent with small fiber neuropathy. A subsequent nerve conduction study revealed an axonal peripheral neuropathy. She was also found by magnetic resonance imaging to have multilevel cervical and lumbosacral degenerative disc disease. The concomitant existence of CPSP, peripheral neuropathy, as well as spinal degenerative disease may have collectively contributed to her symptoms. To our knowledge, these three entities have not been previously described to coexist and contribute to this type of clinical presentation. In particular, the skin biopsy findings have not been described in this setting. Recognizing the coexisting peripheral and central nervous system contributions may have significant clinical implications for both diagnosis and treatment as well as to better understand the bidirectional changes (peripheral and central) that may facilitate pain following nerve injury. This patients' course reinforces the need for a high clinical suspicion for alternative explanations when patients' complaints do not respond adequately to established treatment." @default.
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- W2323767068 date "2012-04-01" @default.
- W2323767068 modified "2023-10-16" @default.
- W2323767068 title "Can bidirectional changes facilitate pain following nerve injury? A case report and discussion" @default.
- W2323767068 doi "https://doi.org/10.1016/j.jpain.2012.01.139" @default.
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