Rare type of CVA???

[mjl1717]

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I know a CVA is usually associated with hemiplegia or hemipareis, dysphonia, those usual non-pain symptoms..

I know it sounds weird but has anyone ever heard of a CVA being associated with PAIN, especially in the neck, back, thighs, legs, possibly even arm pain????😕

 

[Rendar5]

You can get pain from muscle cramping from increased tone that occurs after a stroke. But you don't get pain as a direct result of a CVA. Pain is a phenomenon interpreted by your peripheral nervous system, not your central nervous system.

 

[Rendar5]

As an aside, I'm kind of confused by your question and the way you ask it. What's behind your question?

 

[geogil]

google thalamic pain syndrome. It occurs s/p CVA.

 

[geogil]

You can get pain from muscle cramping from increased tone that occurs after a stroke. But you don't get pain as a direct result of a CVA. Pain is a phenomenon interpreted by your peripheral nervous system, not your central nervous system.

Isn't the pain signal transmitted by the PNS, but interpreted by the CNS?

 

[45408]

As an aside, I'm kind of confused by your question and the way you ask it. What's behind your question?

Word. Looks like a thinly-veiled request...


mjl, if you've having a stroke, stop posting on SDN and go to the hospital. But if my arm was hurting, the last thing on my mind would be "Could this be a stroke?"

 

[Rendar5]

google thalamic pain syndrome. It occurs s/p CVA.

yikes, sounds scary.

 

[Rendar5]

Isn't the pain signal transmitted by the PNS, but interpreted by the CNS?

yeah, that is true. but it's not quite what I meant. It's up to the PNS to interpret a stimulus as pain or not. If it doesn't, then it won't fire. If it does, it will fire and then it's up to the CNS to interpret the PNS interpretation.

 

[Rendar5]

Word. Looks like a thinly-veiled request...


mjl, if you've having a stroke, stop posting on SDN and go to the hospital. But if my arm was hurting, the last thing on my mind would be "Could this be a stroke?"

Maybe it's lupus? or fibromyalgia? or lyme disease? or maybe swine flu? (stoke the hypochondrism!!!!!)

 

[greatnt249]

Maybe it's lupus? or fibromyalgia? or lyme disease? or maybe swine flu? (stoke the hypochondrism!!!!!)

It's never lupus.

Sorry...couldn't help myself.

 

[mjl1717]

Word. Looks like a thinly-veiled request...


mjl, if you've having a stroke, stop posting on SDN and go to the hospital. But if my arm was hurting, the last thing on my mind would be "Could this be a stroke?"

No Prowler, Im not having a stroke.. I swim a lot+

I guess my q is has anyone ever seen the 2% CVA variant- "thalamic pain syndrome"?..

I think I recently saw a case: The 55 year old lady had left sided CVA [in addition had a severe MVA] has right sided hemiparesis/hemiplgegia with contralateral ataxia with muscle spasms/..
Visual disturbances wer NOT noted..

Im wondering is it the norm for this for these patients to be on 2 hefty schedule II narcotics?😕


It appears as if the coticospinal and cortico bulbar are involved..

 

[Rendar5]

muscle spasms hurt a lot.

 

[SouthernSurgeon]

Im wondering is it the norm for this for these patients to be on 2 hefty schedule II narcotics?😕

It is the norm for LOTS of patients to be on hefty schedule II narcotics even if there is no clear clinical indication for it. Welcome to medicine. Chronic pain sucks.

 

[neurolddoc]

Thalamic pain syndrome is definitely something that is seen in clinical practice. The pain is separate from pain produced by the muscle spasm, etc which may occur after a cva.

Many patients will respond to a tricyclic (nortriptyline) or an SNRI which presumable work on central mechanisms to modulate pain.

 

[45408]

It is the norm for LOTS of patients to be on hefty schedule II narcotics even if there is no clear clinical indication for it. Welcome to medicine. Chronic pain sucks.

I was at the medical examiner's office yesterday. Six autopsies. Four of them had active prescriptions for narcotics. Two were heroin overdoses (and one lived in my neighborhood). Five of the six people had drugs or alcohol in their system at the time.

Chronic pain isn't usually the problem. Addiction is.