This article presents recent observations about different recognized centra
l pain syndromes (CPS) and discusses them in light of contemporary microele
ctrode and imaging findings. Different theories regarding the generation of
CPS are reviewed, with an emphasis on difficulties in diagnosis and treatm
ent. The author discourages destructive procedures for treatment of CPS, fa
voring, instead, reversible procedures such as stimulation techniques and d
rug delivery systems.