What Is Central Neuropathy?

The central nervous system encompasses the brain and the spinal cord. Central neuropathy refers to trauma sustained by either or both of them. The central nervous system also encompasses parts of the autonomic nervous system (which controls involuntary functions--for example, internal organs and blood pressure).

Causes

• Central neuropathy can be caused when physical damage is inflicted upon the brain or the spinal cord. For example, this can occur in a gunshot victim or someone who has survived a serious car crash or other accident. Central neuropathy can also be a complication of multiple sclerosis and strokes. Sometimes, the cause of neuropathic pain is never discovered.

Symptoms

• Damage to the central nervous system results in symptoms often felt on both sides of the body, including the genitals, upper extremities or sometimes the rest of the body that is below the injury site. This can be a very painful condition, frequently described as a "twisting knife" or like electric shocks. Damage to the spinal cord can result in paralysis, numbness, burning or stinging pain.

Medications

• There are many options available for neuropathic pain. They include anticonvulsants such as gabapentin, phenytoin, clonazepam, and carbamazepine, as well as tricyclic antidepressants such as nortriptiline and amitriptyline. Topical applications of lidocaine or capsaicin can also be effective.

Spinal Cord Stimulation

• When the neuropathy is severe, oral medications may not be enough to control the pain. One option is spinal cord stimulation. This method utilizes electrical currents (at low levels) to the spinal cord to block pain. This requires surgery, because the device is implanted and may be either self-sustaining or may require a power source outside the body. If the patient desires, the device can be removed in another procedure.

Spinal Pumps

• Also known as pain pumps, these are also implanted in the body during surgery. The device delivers a drug to the spinal cord area for continual pain relief. The drug that is used is typically morphine. This option requires monthly injections (into the pump reservoir) to replenish the drug in the pump. The pump is removable via surgery.

Transcutaneous Electrical Nerve Stimulation

• Often known as TENS, this is an option for those who wish to avoid having a device surgically implanted. The TENS unit delivers electrical currents (low-voltage) through electrodes, external to the body. This method is effective for relieving moderate to moderately severe neuropathic pain.