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Central pain

机译：中枢性疼痛

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Purpose of review: As a result of its accompanying co-morbidity, our lack of understanding regarding its mechanisms, and its resistance to conventional treatment, central pain is one of the most formidable challenges pain physicians are faced with. The objective of this review is to summarize recent advances in our understanding of the etiology, clinical presentation, and treatment of central pain, with special emphasis being placed on studies published within the past year. Recent findings: Recent evidence suggests that not only injuries commonly associated with central pain, such as strokes and spinal cord lesions, but also disorders such as fibromyalgia, phantom limb pain and tension-type headaches may involve central phenomena. Perhaps because of the lack of clinical trials, treatment is still largely based on traditional prescribing methods and anecdotal evidence. Recent studies have indicated possible roles for tricyclic antidepressants, anti-seizure medications, and motor cortex stimulation in the treatment of central pain. Summary: Injury to the spinothalamocortical pathways is a necessary, but not sufficient factor in the pathogenesis of central pain. Perhaps because of the similarities in mechanisms, there is considerable overlap between effective treatments for central pain and those for peripheral neuropathic pain. Our poor understanding of the etiology of central pain and the relative lack of effective treatments emphasize the need for further research into this elusive disorder.
机译：审查目的：由于伴发并存症，我们对其机制缺乏了解以及对常规治疗的抵抗力，中枢性疼痛是疼痛医师面临的最严峻挑战之一。这篇综述的目的是总结我们对病因，临床表现和中枢性疼痛治疗的理解方面的最新进展，特别强调过去一年中发表的研究。最新发现：最新证据表明，不仅通常与中枢性疼痛相关的损伤（例如中风和脊髓损伤），而且还包括诸如纤维肌痛，幻肢痛和紧张型头痛之类的疾病可能涉及中枢现象。也许由于缺乏临床试验，治疗仍然主要基于传统的处方方法和传闻证据。最近的研究表明三环类抗抑郁药，抗癫痫药和运动皮层刺激在中枢性疼痛治疗中可能发挥作用。摘要：在中央疼痛的发病机理中，脊髓锥体细胞途径的损伤是必要的，但不是充分的因素。也许由于机制的相似性，有效的中枢性疼痛治疗方法与周围神经性疼痛的治疗方法之间存在着很大的重叠。我们对中枢性疼痛的病因了解甚少，并且相对缺乏有效的治疗方法，这凸显了对这种难以捉摸的疾病进行进一步研究的必要性。

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