Complete resolution of central neuropathic pain after left frontal cerebral hemorrhage

Complete resolution of central neuropathic pain after left frontal cerebral hemorrhage

Central neuropathic pain is a difficult syndrome to treat because it is frequently resistant to conventional treatment such as oral medication, epidural blocks, and rehabilitative treatment. Advanced neuromodulation treatments such as spinal cord stimulation and an intrathecal morphine pump are the only treatment modalities in many cases. A 62-year-old man, suffering from allodynia of both lower legs and arms after resection of a tumor in the anterior cingulate gyrus underwent surgical implantation of cervical and thoracic spinal cord stimulators to control intractable neuropathic pain. His neuropathic symptoms were completely resolved after an unexpected left frontal cerebral hemorrhage. The patient returned to normal life with minimal disability. This case provides new insight into the central pain processing pathway. In this report, we suggest the superior frontal gyrus is a critical region for the central pain processing pathway. Our case report provides new insight into central pain treatment.