ABSTRACT
A lesion anywhere in the central nervous system can cause neuropathic pain. The International Association for the Study of Pain defines neuropathic pain as that which is initiated or caused by a lesion or dysfunction of the nervous system and can stem from either the peripheral or central nervous system. Implications of pharmacologic treatment trials have led to hypotheses regarding which neurotransmitter systems and/or channels are important in central neuropathic pain. Intrathecal (IT) trials are important as drugs can be administered through an IT drug delivery system. IT baclofen has been shown in an open trial to reduce musculoskeletal, but not neuropathic, pain associated with spasticity following spinal cord injury. Central neuropathic pain states can stem from variable pathologies affecting various levels of the central nervous system, but invariably are severe, dysfunctioning, and all too often humbling in their response to treatment.
