Allodynia in relation to lesion site in central post-stroke pain

Seventy-one percent of 122 patients with central post-stroke pain (CPSP) had allodynia that was tactile-, cold-, or movement-evoked. Site of thalamic (and some infratentorial) lesions as revealed by magnetic resonance imaging (MRI) was correlated in some cases with allodynia type and sensory perception threshold testing (QST). Notably, patients with cold allodynia tend to have more dorsally placed thalamic lesions than those without, and those with movement allodynia more anteriorly placed lesions. Suggestions are made for improved correlation. Perspective: Only about half of patients with CPSP have allodynia (pain caused by innocuous stimulation), such stimulation is usually tactile- or cold-evoked or due to activation of stretch receptors (movement). We have found that, in some of our cases, the type of allodynia may depend on lesion location within the thalamus. (c) 2005 by the American Pain Society.