Stroke Patient Portfolio (PDF) - Buckinghamshire County Council

The Effects of StrokeOther issues which may occur following stroke are detailed below: There are many reasons why peopleexperience pain or discomfortfollowing a stroke and this is mainlybecause they are not as mobile as usual.However there is a pain known as centralpost-stroke pain (CPSP) which is quitedifferent. CPSP rarely starts straight aftera stroke. It is much more likely to beginseveral months after the stroke and maytake as long as two years to appear.A recent study showed that about onein eight people may have experiencedCPSP within six months of a stroke andanother study put the figure as one intwelve people. It is not known exactlywhy CPSP develops. It may arise from thebrain’s efforts to compensate for damageto the pain pathways. Instead of simplyrecovering normal sensation, it losescontrol of the mechanisms which regulatethe intensity of feeling.Sufferers often describe the pain asicy-burning, throbbing or shooting pain.There can be aching like toothache andeven light clothing brushing against theaffected area of skin is painful.The pain tends to be isolated in one partof the body, usually an arm or leg, and isalways on the side of the body affectedby the stroke. CPSP is not difficult todiagnose but doctors are not alwaysaware that it can occur after stroke. Asimple test is to check whether you cantell the difference between the feel of acold teaspoon and a warm finger on theskin of the affected area, or a sharp versusa blunt object. People with CPSP canfeel that there is something on their skinbut have lost the ability to differentiatebetween other types of stimulation.Conventional painkilling drugs, whichblock nerve impulses at the place wheresomething hurts, usually have littleimpact on CPSP because the injury isin the brain. However, low doses ofantidepressant drugs can be helpful forsome people. An anti-epilepsy drug,called gabapentin, has also shown to helpwith painful nerve problems. Speak toyour GP for more information.14