THE NEUROCHEMISTRY OF CENTRAL PAIN - EVIDENCE FROM CLINICAL-STUDIES, HYPOTHESIS AND THERAPEUTIC IMPLICATIONS

Recent evidence suggests that central pain, i.e., pain due to central nervous system damage, may be due to a deranged neurotransmission betw een the sensory thalamus and sensory cortical areas. Central pain can be controlled either by opposing glutamate neurotransmission or potent iating GABAergic transmission. It is speculated that a relative hypofu nction of the GABAergic inhibition both at thalamic and cortical level s leads to a sectorial excitatory hypertonus in those same areas. A bl end of the two should mark each patient. A pharmacological dissection approach is provided that should optimize the treatment, up to now glo bally poor, of central pain. (C) 1998 International Association for th e Study of Pain. Published by Elsevier Science B.V.