Diagnostic criteria for central post-stroke pain

Klit et al. (2009) [6] Hansen et al. (2012) [39] Scholz et al. (2019) [40]
Mandatory criteria:

Pain within an area of the body corresponding to the lesion of the CNS.

History suggestive of a stroke and the start of pain at or after stroke onset.

Confirmation of CNS damage by imaging or negative or positive sensory manifestations in the body part where the damage is located.

Other sources of pain, such as nociceptive or peripheral neuropathic pain, are excluded or considered highly unlikely.

Development of pain with onset at or after the stroke.

Location of pain on the stroke-affected side of the body.

No other apparent of the pain, including pain isolated to the shoulder joint and nearby origin.

Pain is caused by a cerebrovascular lesion, infarct or hemorrhage, of the brain or brainstem.

The pain may be spontaneous or induced, as an increased response to a painful stimulus (hyperalgesia) or a painful response to a normally non-painful stimulus (allodynia).

The diagnosis of central post-stroke pain requires a history of stroke and neuroanatomically plausible distribution of the pain, i.e., pain experienced in the body area reflected in the central nervous tissues damaged by the stroke.

The pain may affect half of the body or a smaller region.

Negative or positive sensory symptoms or sign indicating the involvement of the brain have to be displayed in the body part impacted by the stroke.

Supportive criteria:

No primary relation to movement, inflammation, or other local tissue damage.

Descriptors such as burning, painful cold, electric shocks, aching, pressing, stinging, and piercing needles, although any description of pain can be used.

Hypersensitivity to touch or cold.

CNS: central nervous system.

Korean J Pain 2023;36:408~424 https://doi.org/10.3344/kjp.23220
© Korean J Pain