Treatments

Central Pain Syndrome Treatments

Treatments for central pain syndrome include medical and surgical options.

Medications

Narcotics such as morphine, codeine, hydrocodone and oxycodone often are not effective for central pain syndrome. More often, medications that modulate the neurotransmitters in the brain are used to help control central pain. These medications were originally developed for other purposes such as treating depression and epilepsy:

• Antidepressants: duloxetine, amitriptyline and nortriptyline
• Anticonvulsants: gabapentin, carbamazepine, phenytoin, pregabalin, topiramate and levetiracetam

Surgery

When medications fail to provide adequate relief, surgical procedures may help. The primary surgical procedures used for central pain are:

• Motor cortex stimulation: Using computer-guided surgical techniques, stimulating electrodes are placed on the covering of the brain over the region controlling movement of the painful body area. An implanted pulse generator (battery) sends constant electric pulses to the area to relieve pain.
• Deep brain stimulation: One or two small wires are placed deep in the areas of the brain that relay pain signals. Microelectrode recording (brain mapping) techniques are used to precisely localize the area to place the electrode. An implanted pulse generator (battery) sends constant electrical pulses to the area to relieve pain.