How prevalent is centrally mediated pain following middle cerebral artery (MCA) stroke?

Updated: Feb 20, 2018
  • Author: Daniel I Slater, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Centrally mediated pain is also seen in 12-25% of patients with hemiplegia. This is formally described as complex regional pain syndrome type I or reflex sympathetic dystrophy. [28] The most common presentation is shoulder-hand syndrome, which manifests as pain in both the hand and shoulder, usually sparing the elbow and forearm. The phenomenon follows stages of development, with initial and often severe allodynia, followed by skin and muscle atrophy and decreased range of motion, and, finally atrophy and deformity, over several months. Clinical examination reveals pain with metacarpal flexion and passive range of the shoulder that is often rapid.


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