Generally, CPSP presents days to weeks after the stroke with chronic disabling pain, dysesthesia, allodynia, and
hyperpathia. CPSP is a principal obstacle to rehabilitation following stroke.
History and physical examination revealed intense pain, allodynia,
hyperpathia, hyperemia, contracture of the wrist, of the metacarpophalangeal joints and of the proximal interphalangeal joints, abnormal sweating, and increased hair growth over the dorsum of the hand, hypoesthesia, dystrophic nail changes and tremor in the right hand.
It should also focus on the musculoskeletal system (eg, myofascial pain, fibromyalgia, inflammation, deformity, posture, leg length discrepancy), as well as the neurologic system (eg, search for weakness, hyperalgesia,
hyperpathia, allodynia, numbness, paresthesia, other neurologic impairments).
Classical presentation of thalamic stroke is usually sensory with hemi anesthesia or thalamic
hyperpathia (Dejerine-Roussy syndrome).
Other signs might include focal
hyperpathia along the spine, bowel or bladder dysfunction, reluctance to jump or climb stairs, crying in pain and arched back (kyphosis).
(2) Similarly, some have suggested that even though the radiation of pain following local trauma seemed to resemble causalgia, (20) there was a lack of
hyperpathia and changes in the soft tissue, bones, and blood vessels as well as a poor response to sympathetic blockade, thus making clinical features of PLMT inconsistent with known radicular disorders.
There were no allodynia, hyperesthesia,
hyperpathia or sudomotor changes as hyperhidrosis in physical examination and no demineralization or osteoporosis in radiological examination.
Hyperpathia is an abnormally painful and exaggerated reaction to painful stimuli while Allodynia is an abnormal perception of pain from a normally non-painful mechanical or thermal stimulus.
