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We report 5 stroke patients with lesions affecting the insula and parietal operculum sparing the postcentral gyrus (somatosensory cortical area SI); 3 had spontaneous central poststroke pain (CPSP) and 2 did not. All were imaged and underwent quantitative sensory threshold tests, though not all modalities were tested in all subjects. Tactile thresholds were(More)
Somatic sensory perception thresholds (warm, cold, hot pain, touch, pinprick, vibration, two-point discrimination), allodynia and skin temperature were assessed in the affected area of 42 patients with unilateral postherpetic neuralgia (PHN) and 20 patients who had had unilateral shingles not followed by PHN (NoPHN), and in the mirror-image area on the(More)
A simple device is described, consisting of 12 weighted 23 gauge disposable needles (0.2 to 5.2 g), for testing sensation in busy diabetic clinics. The pinprick sensory threshold (PPT) is the lightest weighted needle which consistently elicits a sharp sensation. The subjects were 48 healthy controls (hospital staff), 44 diabetic patients without neuropathic(More)
Four subjects with small restricted cerebral cortical infarcts have been examined. One had a lesion confined to the parietal operculum (SII), while in the second the SII lesion also encroached on the posterior insula; in the third subject, both banks of the sylvian fissure and the dorsal insula were involved, while in the fourth the lesion involved the(More)
  • D Bowsher
  • 1996
OBJECTIVES To study the clinical and pathophysiological features of central pain due to damage to the CNS. METHODS 156 patients (mostly with ischaemic strokes, some with infarct after subarachnoid haemorrhage and other cerebral conditions; one with bulbar and others with spinal pathology) with central pain have been investigated clinically and varying(More)
OBJECTIVE To correlate MRI and sensory changes in patients with spontaneous lesions in the cerebral "pain pathway." METHODS The authors used MRI and quantitative somatosensory testing in 73 patients with central poststroke pain (CPSP) and in 13 patients with pain-free stroke with sensory deficit. RESULTS Lesions in any part of the discriminatory(More)
Intravenous naloxone has been claimed to produce pain relief in opioid-resistant central post-stroke pain (CPSP, 'thalamic syndrome'). In a double-blind trial, carried out in 20 patients with established CPSP, naloxone (up to 8 mg in 20 ml vehicle) was tested against normal saline; each patient was randomly given naloxone or saline and the other substance 2(More)