Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Malawi Med J. 2020 Sep;32(3):132-138. doi: 10.4314/mmj.v32i3.5.
Central post-stroke pain (CPSP) is a poorly diagnosed chronic pain. It is under-treated and usually mismanaged.
To establish the prevalence of CPSP and its management in stroke clinics at a tertiary hospital.
This was a cross-sectional design with stroke patients and health professionals from the stroke clinic at the tertiary hospital in Zimbabwe.
Out of 166 stroke survivors, 8% had CPSP. Younger age (<60 years) was significantly associated with CPSP (P<0.003). Pain characteristics of CPSP were hyperaesthesia (10, 71%), electric shocks (9, 64%), temperature allodynia (9, 64%) and allodynia (12, 86%). Ten health professionals participated in the study: one (10%) reported using Douleur Neuropathique 4 (to diagnose neuropathic pain) and two (20%) reported using sensory tests. Four patients (44%) were on paracetamol (acetaminophen) and on weak opiates such as codeine. None of the patients were on anticonvulsants or antidepressants. Two medical doctors (50%) used weak opiates as second-line management. Five patients (36%) reported receiving a combination of massage, stretching, general exercise and moist heat or cryotherapy.
The prevalence of CPSP in the study group is within international range. There is a need for appropriate management and use of tests and outcome measures for diagnosis of CPSP.
中枢性卒中后疼痛（CPSP）是一种诊断不明确的慢性疼痛。它的治疗不足，通常管理不当。
在津巴布韦一家三级医院的卒中诊所，确定 CPSP 的患病率及其管理情况。
这是一项横断面设计研究，纳入了来自该三级医院卒中诊所的卒中患者和卫生专业人员。
在 166 名卒中幸存者中，8%患有 CPSP。年龄较轻（<60 岁）与 CPSP 显著相关（P<0.003）。CPSP 的疼痛特征包括感觉过敏（10，71%）、电击感（9，64%）、温度性痛觉过敏（9，64%）和痛觉过敏（12，86%）。10 名卫生专业人员参与了这项研究：1 名（10%）报告使用 Douleur Neuropathique 4（用于诊断神经病理性疼痛），2 名（20%）报告使用感觉测试。4 名患者（44%）服用扑热息痛（对乙酰氨基酚）和弱阿片类药物，如可待因。没有患者服用抗惊厥药或抗抑郁药。2 名医生（50%）将弱阿片类药物作为二线治疗。5 名患者（36%）报告接受按摩、伸展、一般运动和湿热敷或冷疗的组合治疗。
研究组中 CPSP 的患病率处于国际范围内。需要适当管理，并使用测试和结局措施来诊断 CPSP。
