About thalamic pain syndrome

What is thalamic pain syndrome?

Central pain syndrome is a neurological disorder caused by damage to the central nervous system (CNS). Common symptoms include pain and loss of sensation, usually in the face, arms and/or legs. Pain is often constant and can be mild, moderate, or severe in intensity. Affected individuals may become hypersensitive to painful stimuli. The specific type of pain experience can vary from one individual to another based, in part, upon the underlying cause of the disorder and the area of the central nervous system affected. Central pain syndrome can potentially disrupt an individual's daily routine. In severe cases, the pain can be agonizing and unrelenting and dramatically affect a person's quality of life. Central pain syndrome can develop following a variety of conditions including stroke, multiple sclerosis, spinal cord injury, or brain tumors.

For years, it was believed that the majority of cases of central pain syndrome were due to damage of the thalamus most often caused by a stroke. The disorder was frequently referred to as thalamic pain syndrome or Dejerine-Roussy syndrome after two French neurologists who reported on the disorder in the early 1900s. In fact, to some degree central pain became synonymous with thalamic pain syndrome for many years. However, researchers now know that damage to other areas of the CNS can cause central pain syndrome, including cases following a stroke. Consequently, the preferred name for this group of disorders is central pain syndrome to acknowledge that damage to various areas of the CNS (and not predominantly the thalamus) can cause central pain and that a stroke is not necessarily the primary cause. The preferred term for the specific subtype of central pain syndrome caused by CNS damage due to a stroke is central post-stroke pain.

What are the symptoms for thalamic pain syndrome?

Burning or tingling pain symptom was found in the thalamic pain syndrome condition

Thalamic Pain syndrome is a tragic result of a cerebrovascular event (CVA).

Symptoms

  • The patient's Discomfort is concentrated, neuropathic, and related with temperature fluctuations.
  • Patients frequently experience hyperalgesia and allodynia.
  • Numbness on the affected side is the most common symptom of Dejerine-Roussy syndrome.
  • Numbness is replaced with Burning and tingling sensations in these cases, which vary in severity across all cases.
  • The vast majority of those reporting have severe and incapacitating symptoms.
  • Hypersensitivity, commonly shown as dysaesthesia or allodynia, can accompany Burning and tingling.
  • Rarely, do some individuals experience significant Chronic Pain with little or no triggers.
  • Allodynia is Pain caused by stimulation that would not typically induce pain. For example, one patient suffers from excruciating Discomfort whenever a wind brushes his skin.
  • Most allodynia sufferers report Pain with touch and pressure, but some can be hypersensitive to warmth.
  • The term dysaesthesia refers to an unpleasant, abnormal feeling of touch. It frequently manifests as pain. This disorder is caused by thalamic lesioning.
  • This type of neuropathic Pain can be any combo of itching, tingling, scorching, or searing sensations that occur spontaneously or in response to stimuli.
  • Between one week and a few months following a thalamic stroke, allodynia and dysaesthesia replace numbness.
  • In general, after the growth of Pain has ceased, the type and level of Pain will remain constant and, if untreated, will last the rest of one's life.
  • As a result, many will seek Pain relief and try to adjust to their new lifestyles as best they can.


Symptoms
Burning or tingling pain,Weakness on one side of the body,Issues with vision,Difficulty swallowing,Loss of memory,Burning,Short bursts of sharp, excruciating pain
Conditions
Stroke,Increased rates of depression,Frequent falls,Urinary tract infections,Chest infections such as pneumonia
Drugs
Gabapentin,Pregabalin,Carbamazepine,Phenytoin,Lamotrigin,Amitriptylin,Lamotrigine,Mexiletine

What are the causes for thalamic pain syndrome?

Thalamic pain syndrome is a tragic result of a cerebrovascular event (CVA).

  • Thalamic pain syndrome develops following damage to the central nervous system - the brain, brainstem or spinal cord.
  • The damage is most often associated with a stroke, multiple sclerosis, spinal cord (but also brain) injury or brain tumors.
  • Central pain syndrome can also develop after neurosurgical surgeries that involve the brain or spine.
  • Allodynia is pain caused by stimulation that would not typically induce pain. For example, one patient suffers from excruciating discomfort whenever a wind brushes his skin.
  • Most allodynia sufferers report pain with touch and pressure, but some can be hypersensitive to warmth.
  • The term dysaesthesia refers to an unpleasant, abnormal feeling of touch. It frequently manifests as pain. This disorder is caused by thalamic lesioning.
  • This type of neuropathic pain can be any combo of itching, tingling, scorching, or searing sensations that occur spontaneously or in response to stimuli.
  • Between one week and a few months following a thalamic stroke, allodynia and dysaesthesia replace numbness.
  • In general, after the growth of pain has ceased, the type and level of pain will remain constant and, if untreated, will last the rest of one's life. As a result, many will seek pain relief and try to adjust to their new lifestyles as best they can.


Symptoms
Burning or tingling pain,Weakness on one side of the body,Issues with vision,Difficulty swallowing,Loss of memory,Burning,Short bursts of sharp, excruciating pain
Conditions
Stroke,Increased rates of depression,Frequent falls,Urinary tract infections,Chest infections such as pneumonia
Drugs
Gabapentin,Pregabalin,Carbamazepine,Phenytoin,Lamotrigin,Amitriptylin,Lamotrigine,Mexiletine

What are the treatments for thalamic pain syndrome?

There aren't many effective treatment alternatives available for Centralized neuropathic pain or Thalamic Pain Syndrome. It is advised to use complementary and integrative treatment modalities to lessen discomfort and enhance quality of life. Pharmaceutical choices include opioid analgesics and neuropathic painkillers. Neuromodulation, surgery, and deep brain stimulation are more intrusive therapeutic options.

Effective treatment available for Thalamic Pain Syndrome

  • Although there haven't been any in-depth investigations, case studies have demonstrated acupuncture's usefulness in treating post-stroke pain. Additionally, the use of cold water vestibular caloric stimulation in the treatment of central post-stroke pain has produced positive outcomes in treating Thalamic Pain Syndrome.
  • Brain stimulation therapy: For situations that are refractory to other treatments, deep brain stimulation may be a possibility. Another effective therapeutic option for cases of central post-stroke pain is radiation therapy. After a CVA, cognitive-behavioral treatment helps patients avoid developing depression.
  • Pharmacological treatment: People with Thalamic pain syndrome typically get little to no relief from traditional painkillers (such NSAIDs). However, for the majority of affected people, pharmacological therapy continues to be the primary line of treatment.
  • In controlled studies, two medications - amitriptyline and lamotrigine have shown promise, particularly for people with central pain with a brain cause. An antidepressant is amitriptyline. Lamotrigine is a seizure medication (anticonvulsant). Mexiletine, an antiarrhythmic, and local anaesthetics such lidocaine can be useful.
  • The side effects of pharmacological therapy frequently have a negative impact on their efficacy

What are the risk factors for thalamic pain syndrome?

After a cerebrovascular accident, the terrible symptom known as Thalamic pain syndrome develops.

  • Patients frequently experience allodynia and hyperalgesia. Up to 8% of stroke patients will experience thalamic pain syndrome, which is a pretty significant prevalence.
  • Despite being frequent after a stroke, diagnosis is frequently challenging. After a CVA, a patient's symptoms often take longer to manifest. A person who has experienced a CVA of the thalamus might not feel pain at all for months or years following their stroke.


Risk factors for the Thalamic pain syndrome
These are the risk factors involved in the Thalamic pain syndrome.

  • Being overweight
  • Not exercising
  • Alcohol use disorder
  • Taking drugs like cocaine, methamphetamine, or Adderall
  • High blood pressure
  • Smoking cigarettes
  • High cholesterol
  • Diabetes
  • Sleep apnea
  • Cardiovascular disease
  • Heart failure
  • Heart defects
  • Heart infection
  • Abnormal heart rhythms
  • Family history of strokes, heart attacks
  • COVID-19
  • People over the age of 55
  • African American people
  • Men
  • Individuals on birth control or hormone therapy


Complications due to Thalamic pain syndrome

  • The patient's life will have a worse quality if they are in constant discomfort, elevated depression rates, as well.
  • There are other side effects connected to Thalamic pain syndrome that are not just related to thalamic pain syndrome.
  • Frequent falls, UTIs, and chest infections like pneumonia are a few medical sequelae of a stroke.
  • Depression and the emergence of pressure sores are other common worries following a Thalamic pain syndrome.


Symptoms
Burning or tingling pain,Weakness on one side of the body,Issues with vision,Difficulty swallowing,Loss of memory,Burning,Short bursts of sharp, excruciating pain
Conditions
Stroke,Increased rates of depression,Frequent falls,Urinary tract infections,Chest infections such as pneumonia
Drugs
Gabapentin,Pregabalin,Carbamazepine,Phenytoin,Lamotrigin,Amitriptylin,Lamotrigine,Mexiletine

Is there a cure/medications for thalamic pain syndrome?

A thalamic cerebrovascular accident can result in Thalamic pain syndrome, which is a chronic and disabling neuropathic pain disease.

Medication or Cure available for the Thalamic pain syndrome

  • Antidepressants: The medication and cure of Thalamic pain syndrome is challenging and frequently only partially effective. Older antidepressants like amitriptyline (Elavil), though they have adverse effects like tiredness, dry mouth, and dizziness, seem to lessen the discomfort. The central pain syndrome is also treated with duloxetine (Cymbalta), a more recent antidepressant medication that has less side effects than amitriptyline.
  • Antiepileptic medications: Antiepileptic medications (AEDs) seem to interfere with the sensory nerves ability to transmit central pain signals. Gabapentin (Neurontin) and pregabalin are the two AEDs for central pain syndrome that are most frequently utilised (Lyrica). Topiramate and carbamazepine (Tegretol) are two more AEDs that are occasionally used to relieve pain (Topamax). These drugs seldom provide a cure but frequently lessen the severity of the pain.
  • Topical medicine treatment: Topical medicines, physical therapy methods, acupuncture, and electrical stimulation delivered through the skin are additional treatments for Thalamic pain syndrome. Although there isn't a lot of proof that these treatments are effective, they might be useful in some circumstances. Neurosurgical techniques like deep brain stimulation with electrodes may be employed in the most difficult instances, but more research is needed to see how beneficial these therapies are.


Symptoms
Burning or tingling pain,Weakness on one side of the body,Issues with vision,Difficulty swallowing,Loss of memory,Burning,Short bursts of sharp, excruciating pain
Conditions
Stroke,Increased rates of depression,Frequent falls,Urinary tract infections,Chest infections such as pneumonia
Drugs
Gabapentin,Pregabalin,Carbamazepine,Phenytoin,Lamotrigin,Amitriptylin,Lamotrigine,Mexiletine

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