Боль после инсульта и реабилитация (клиническое наблюдение)

Abstract

Pain is one of the most common symptoms that occur in neurological practice. Pain after a stroke is a common clinical problem insufficiently diagnosed and treated, which is due to differences in methods aimed at solving the problem. For instance, there are different definitions of the pain type, study designs, examined patient cohorts and, commonly, neglects by doctors of an active patient survey on this complaint. This article describes the most common pain syndromes, including central post-stroke pain, shoulder pain after stroke, complex regional pain syndrome and pain associated with spasticity. The incidence of various post-stroke pain types, their clinical manifestations and risk factors for occurrence are presented. The article also shows main directions of pharmacological and non-pharmacological treatment, medical rehabilitation of patients with post-stroke pain syndromes. Medical rehabilitation of patients with post-stroke pain syndromes includes functional status assessment, goal setting in rehabilitation, selection of measures and regular assessment of ongoing rehabilitation activities with the patient and relatives participation. The article presents a case study that reflects the following problem — hemiplegic shoulder pain after stroke which is commonly found in practice, persists for a long-term period and requires diagnosis at each hospitalization in the department of rehabilitation with the selection of individual treatment depending on the specific clinical case. KEYWORDS: post-stroke pain syndromes, ischemic stroke, risk factors, medical rehabilitation. FOR CITATION: Pizova N.V., Pizov N.A., Mareev M.S. Post-stroke pain and rehabilitation (case report). Russian Medical Inquiry. 2023;7(10):672–679 (in Russ.). DOI: 10.32364/2587-6821-2023-7-10-10.