Clinical features of central post-stroke pain

Objective To analyze the clinical features of central post-stroke pain (CPSP). Methods A total of 1 130 patients including 289 cases of hemorrhagic stroke and 841 cases of ischemic stroke, who visited the neurology department one month after stroke during July 2013 to June 2014, were enrolled in the study. The patients were divided into 3 groups: CPSP group (n=80), non-CPSP pain group (n=467) and no-pain group (n=583). The general conditions and clinical features of patients were documented; depression and anxiety was evaluated with Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS); the severity of pain was assessed with Visual Analogue Scale (VAS), pain drawing, sensory tests and brief pain inventory (BPI). Results There were no statistically significant differences in age, course of disease, types of stroke, size of lesions, lesion distribution in cerebral regions and coexistent diseases among three groups. Compared with non-CPSP pain group and no-pain group, CPSP group had higher proportion of lesions in right side [66.2%(53/80) vs. 40.5%(189/467), 66.2%(53/80) vs. 38.9%(227/583), χ2=13.86, 25.97, both P=0.001]. Sensory tests in CPSP group were all abnormal. No significant differences were found in scores of VAS(60.4±6.8 vs. 58.7±5.8), BPI(5.4±1.8 vs. 5.2±1.6), SAS(56.7±4.3 vs. 52.8±3.9) and SDS (54.9±4.1 vs. 55.1±4.4) between CPSP group and non-CPSP pain group(t=0.851, 0.350, 0.674, 0.335, P=0.397, 0.727, 0.503, 0.742). But compared with no-pain group, patients in CPSP group had higher scores of SAS and SDS (t=68.38, 33.65, both P=0.000). Ratio of mRS≤2 in CPSP group [36.6%(29/80)] was lower than that of no pain group [61.6%(359/583), χ2 =12.503, P=0.000]. Patients in CPSP group received more combined analgesic therapy than non-CPSP pain group [32.5%(26/80) vs. 14.6%(68/467), χ2 =8.651, P=0.001]. Conclusion CPSP may affect the prognosis of patients with stroke, clinical evaluation and effective intervention are necessary. Key words: Stroke; Neuralgia; Central; Pathological conditions, signs and symptoms; Questionaires