DEFINITIONS

Ever since Dejerine and Roussy's description of central pain (CP) after thalamic stroke in 1906, thalamic pain (itself part of the thalamic syndrome) has remained the best-known form of CP and it has often – misleadingly – been used for all kinds of CP. Since CP is due to extrathalamic lesions in the majority of patients, this term should be discarded in favor of the terms central pain of brain–brainstem or cord origin (BCP and CCP). Other terms that are now obsolete and should be discarded include pseudothalamic pain (i.e., CP caused by extrathalamic lesions) and anesthesia dolorosa, when this refers to CP in an anesthetic region caused by neurosurgical lesions. If a stroke at whatever level is the cause of CP, the term central post-stroke pain (CPSP) is used. Even though some clinical features are similar, peripheral neuropathic pain (PNP) is not CP.

CP is akin to central dysesthesias/paresthesias (CD) and central neurogenic pruritus (CNP): actually, these are facets of a same disturbance of sensory processing following central nervous system (CNS) lesions. Dysesthesias and paresthesias differ from pain in their being abnormal unpleasant and non-unpleasant sensations with a nonpainful quality. While contributing to suffering, they can also be found in PNP. Dysesthetic pain used as a synonym of CP must also be abandoned.