Central neuropathic facial pain
- Ivan Garza, MD
Ivan Garza, MD
- Assistant Professor of Neurology
- Mayo Clinic College of Medicine
By definition, "central pain" is neuropathic pain caused by a lesion or dysfunction in the central nervous system. The clinical presentation can be quite variable among patients . The current International Classification of Headache Disorders recognizes two entities that are central causes of facial pain :
●Central neuropathic pain attributed to multiple sclerosis
●Central post-stroke pain
This topic will discuss these conditions. Other causes of facial pain are reviewed elsewhere. (See "Overview of craniofacial pain".)
A lesion at any level of the central nervous system from the spinal trigeminal nucleus or spinal dorsal horn to the cerebral cortex has the potential for causing central neuropathic facial pain. There may be a higher risk for developing central pain when the spinothalamic and quintothalamic pathways are affected, compared with suprathalamic lesions .
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- GENERAL CHARACTERISTICS OF CENTRAL PAIN
- CENTRAL NEUROPATHIC PAIN ATTRIBUTED TO MULTIPLE SCLEROSIS
- CENTRAL POST-STROKE PAIN
- PHARMACOLOGIC TREATMENT
- Choice of therapy
- - Carbamazepine
- - Amitriptyline
- - Gabapentin
- - Pregabalin
- - Lamotrigine
- NEUROMODULATION AND SURGERY
- SUMMARY AND RECOMMENDATIONS