INCIDENCE OF CENTRAL POSTSTROKE PAIN
INCIDENCE OF CENTRAL POSTSTROKE PAIN
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DOI：
10.1016/0304-3959(94)00144-4
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发表时间：
1995-05-01
期刊：
影响因子：
7.4
通讯作者：
JENSEN, TS
中科院分区：
文献类型：
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作者：
ANDERSEN, G;VESTERGAARD, K;JENSEN, TS
中枢性中风后疼痛（CPSP）是一种神经性疼痛综合征，其特征是中风后发生的身体部位持续或间歇性疼痛，并与疼痛身体部位的感觉异常相关。本研究前瞻性地描述了中风后第一年的 CPSP，并描述了与 CPSP 综合征相关的脑血管病变和神经体征。 267 名连续入院的年龄小于 81 岁的患者在中风后第一周、第 1、6 和 12 个月接受了检查。使用对侧面部和四肢作为对照，研究对触觉（棉绒）、温度（20 摄氏度和 40 摄氏度）和针刺的敏感性。 CT 扫描在中风后 8（中位）天（范围：1-34 天）进行。 207 名 (78%) 存活至少 6 个月且能够可靠沟通的患者构成了这项研究的基础。 87 名 (42%) 患者中至少发现一次异常感觉体征。 16 名 (8%) 患者中发现了 CPSP，其中除 1 名患者外，所有患者都诱发了感觉迟钝或异常性疼痛。另外 1 名患者有持续性诱发感觉迟钝但否认疼痛。 CPSP 与性别或年龄无关。在患有单一急性脑损伤的患者中，损伤的大小或位置与 CPSP 的存在之间没有关系。 6 名 (3%) 患者疼痛较轻，10 名 (5%) 患者疼痛为中度至重度。疼痛性质通常是撕裂样或疼痛。 15 名 (94%) 患者的温度、触觉和疼痛感觉下降，9 名 (56%) 患者报告对冷刺激有异常疼痛，另外 9 名 (56%) 患者报告对触摸有异常疼痛。 10 名患者（63%）在中风后 1 个月内出现疼痛，3 名患者（19%）在中风后 1 至 6 个月内出现疼痛，3 名患者（19%）在中风后 6 个月以上出现疼痛。
Central post-stroke pain (CPSP) is a neuropathic pain syndrome characterized by constant or intermittent pain in a body part occurring after stroke and associated with sensory abnormalities in the painful body part. This study describes CPSP prospectively during the first year after stroke and characterizes the cerebrovascular lesions and neurological signs associated with the CPSP syndrome. Two hundred and sixty-seven consecutively admitted patients younger than 81 years were examined in the first week, at 1, 6 and 12 months after stroke. Sensibility to touch (cotton wool), temperature (20 degrees C and 40 degrees C), and pinprick was studied using the contralateral face and extremity as control. A CT scan was done 8 (median) days (range: 1-34 days) after stroke. Two hundred and seven (78%) patients surviving at least 6 months who were able to communicate reliably formed the basis of the study. Abnormal sensory signs were found at least once in 87 (42%) patients. CPSP was found in 16 (8%) patients of whom all but 1 patient also had evoked dysesthesia or allodynia. Further 1 patient had persistent evoked dysesthesia but denied pain. CPSP was not related to sex or age. In patients with single acute cerebral lesions there were no relation between size or location of the lesions and the presence of CPSP. The pain was light in 6 (3%) patients and moderate to severe in 10 (5%) patients. The pain quality was usually lacerating or aching. Fifteen (94%) patients had decreased temperature, touch and pain sensibility and 9 (56%) reported allodynia to cold stimulation and another 9 (56%) patients reported this to touch. Pain onset was within 1 month after stroke in 10 (63%) patients, between 1 and 6 months in 3 (19%) patients and more than 6 months after stroke in 3 (19%) patients.