Since the pioneer work of Head and Holmes,1 the physiological and psychological aspects of central pain have been the subject of many studies. Central pain is of specific character: It is severe, it is of burning quality, it affects the whole personality and may cause changes in behavior, it is aggravated by emotional influences and sensory stimuli, and it is generally not alleviated by the usual analgetics. Frequently the pain does not leave the patient during the night and may be so severe as to lead to suicide. At times it is accompanied by vasomotor and trophic disturbances.
In spite of numerous clinical and experimental investigations, complete understanding of the problem of central pain has not yet been achieved. Since the work of Dejerine and Roussy,2 the thalamus and its cerebral connections are held responsible for the central pain sensation.
The mechanism by which damage to the thalamus
de VRIES A, BORNSTEIN B, FRIEDMAN E. Thalamic Syndrome Due to Cerebral Embolism in Rheumatic Heart Disease: Successful Treatment with Cortisone. AMA Arch Intern Med. 1957;99(6):1001–1005. doi:10.1001/archinte.1957.00260060159011
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