Post-stroke Central Neuropathic Pain: Prevalence and Associated Risks Factors

Introduction : Stroke can lead to complications such as post-stroke central neuropathic pain (PSCNP), which is often underdiagnosed in Sub-Saharan Africa. Objective : to determine the frequency and predicting factors of PSCNP at the Douala General Hospital. Methods: This hospital-based, cross-sectional analytic study was conducted in the neurology unit from January 1 to May 31, 2019. Two patient groups were included: Group 1 (stroke+), consisting of confirmed stroke patients with a stroke onset of over one month, no PSCNP symptoms prior to the stroke, and no other causes of central or peripheral neuropathic pain; and Group 2 (stroke-), comprising patients with no history of stroke, matched by age, sex, and cerebrovascular risk factors with Group 1. The “Douleur neuropathique 4” (DN4) questionnaire was used to diagnose PSCNP. Logistic regression was performed to identify PSCNP predictors. Results : A total of 301 patients (100 stroke+ and 201 stroke-) were included. The prevalence of PSCNP was 27% in stroke+ and 8.95% in stroke- [p <0.001; OR = 3.760; 95% CI: 1.953-7.241]. Independent predictors of PSCNP were alcoholism [p = 0.001, OR = 9.704, 95% CI = 2.630 - 35.805], hemorrhagic stroke [p = 0.003, OR = 8.534, 95% CI = 2.068 - 35.214], and obesity [p = 0.001, OR = 9.324, 95% CI = 2.487 - 34.963]. Conclusion : Stroke increases the risk of developing PSCNP by fourfold. Alcohol use, hemorrhagic stroke, and obesity are significant predictors and should be carefully monitored in PSCNP assessments.