Abstract
Central Pain Syndrome is a painful constellation of symptoms and signs initiated or caused by a primary lesion or disease affecting the central nervous system. Central pain may be associated with heterogeneous etiologies that result in pathophysiologic changes in the brain and/or spinal cord. These pathologies of the central nervous system are hypothesized to result in increased activation of excitatory neuronal systems or “pain generator” pathways as well as decreased neuronal inhibition that leads to “disinhibition” of pain regulatory pathways. Although diverse in nature and presentation, common themes emerge in the pathophysiology and treatment of central pain states. A multimodal strategy of psychological, physical, pharmacologic, and surgical treatments is utilized as the physician partners with the patient through therapeutic trials directed at developing optimal treatment plans.