什么是中央疼痛综合症？

Damage to the central nervous system (CNS) can cause a neurological disorder called central pain syndrome (CPS). The CNS includes the brain, brainstem, and spinal cord. Several other conditions can cause it like:

  • a stroke
  • brain trauma
  • 肿瘤
  • 癫痫

People with CPS typically feel different types of pain sensations, such as:

  • 酸痛
  • 燃烧
  • 尖锐的痛苦
  • numbness

The symptoms vary widely among individuals. It can start immediately after a trauma or other condition, or it may take months or years to develop.

No cure for CPS is available. Pain medications, antidepressants, and other types of medications can usually help provide some relief. The condition can dramatically affect quality of life.

CPS的主要症状是疼痛。疼痛在个人之间变化很大。它可以是以下任何一种：

  • 持续的
  • 间歇性
  • 限于特定的身体部位
  • 广泛的全身

人们通常描述痛苦作为以下任何一种：

  • 燃烧
  • 酸痛
  • prickling or tingling, which is sometimes called “pins and needles”
  • stabbing
  • itching that turns painful
  • 冷冻
  • 震惊
  • 撕裂

疼痛通常是中度至重度。疼痛甚至可以被一些人称为痛苦。在严重的情况下，即使通过衣服，毯子或强风轻轻地触动，CPS的人可能会疼痛。

A variety of factors may make the pain worse. These factors include the following:

  • 触碰
  • stress
  • 愤怒
  • other strong emotions
  • 运动，如锻炼
  • 反思，不自主的运动，如打喷嚏或打扫
  • 响亮的声音
  • 明亮的灯光
  • 温度变化，尤其是寒冷的温度
  • 日晒
  • 雨
  • wind
  • barometric pressure changes
  • 高度变化

In most cases, CPS remains a lifelong condition.

CPS refers to pain that comes from the brain and not from the peripheral nerves, which are outside of the brain and spinal cord. For this reason, it differs from most other pain conditions.

疼痛通常是对有害刺激的保护性，例如触摸热炉。没有有害刺激导致CPS发生的疼痛。相反，大脑的伤害会产生疼痛的感知。这种损伤通常发生在丘脑中，大脑内的结构，用于将感觉信号处理到大脑的其他部分。

可以导致CPS的最常见条件包括：

  • 脑出血
  • a stroke
  • multiple sclerosis
  • brain tumors
  • 一个动脉瘤
  • 脊髓损伤
  • 创伤性脑我njury
  • 癫痫
  • 帕金森病
  • surgical procedures that involve the brain or spine

The中央疼痛综合征基金会estimates that nearly 3 million people in the United States have CPS.

CPS can be difficult to diagnose. The pain may be widespread and may seem unrelated to any injury or trauma. No single test is available to enable your doctor to diagnose CPS.

Your doctor will review your symptoms, perform a physical exam, and ask about your medical history. It’s very important to inform your doctor about any conditions or injuries you have now or may have had in the past, and any medications you’re taking. CPS doesn’t develop by itself. It only occurs following an injury to the CNS.

CPS难以治疗。有时使用止痛药，如吗啡，但并不总是成功的。

Some people can manage their pain with antiepileptic or antidepressant medications, such as:

  • amitriptyline (Elavil)
  • Duloxetine（Cymbalta）
  • 加巴亨坦（Neurontin）
  • Praetabalin（莱卡内）
  • carbamazepine（tegretol）
  • topiramate (Topamax)

可能有助于包括：

  • transdermal creams and patches
  • 医疗大麻
  • 肌肉松弛剂
  • 镇静剂和睡眠艾滋病

通常，这些药物会降低疼痛，但它们不会让它完全消失。通过试验和错误，患者及其医生最终会发现药物或最佳的药物组合。

Neurosurgery is considered a last resort. This type of surgery involves deep brain stimulation. During this procedure, your doctor will implant an electrode called a neurostimulator in specific parts of your brain to send stimulation to the pain receptors.

A primary care doctor will typically be the first doctor to discuss your symptoms and check your medical history and current health. Once certain conditions are ruled out, your doctor may refer you to a specialist for more testing and treatment.

Specialists who treat or help manage CPS include the following:

Neurologist

神经科医生是一名专门从事神经系统疾病的医生，包括大脑，脊髓和神经。他们通常熟练用于治疗慢性疼痛。在决定哪个神经科学家之前，您可能需要在决定哪一个可以帮助您管理痛苦。

Pain specialist

痛苦专家通常是一位训练神经学或麻醉学的医生。它们专注于疼痛管理，并使用各种方式治疗疼痛，包括口服药物和将某些药物注射到疼痛部位以缓解疼痛。

物理治疗师

A physical therapist is a professional who can help you reduce pain and improve mobility.

心理学家

CPS often affects your relationships and emotional well-being. A psychologist or therapist will discuss the emotional issues with you.

CPS can be painful. It can keep you from participating in social events and greatly impact your daily life. It can lead to emotional problems and other complications including:

  • stress
  • 焦虑
  • 沮丧
  • fatigue
  • sleep disturbances
  • 关系问题
  • 愤怒
  • 减少生活质量
  • isolation
  • 自杀的念头

CPS并没有生命危及生命，但该条件对大多数人来说造成相当大的困难。CPS可能会扰乱日常生活。

In severe cases, the pain can be severe and greatly impact your quality of life. Some people can manage the pain with medications, but the condition typically lasts for the rest of a person’s life.