Dor Central e Acidente Vascular Cerebral: Uma Breve Revisão Narrativa
DOI:
https://doi.org/10.24950/R/129/20/2/2021Palavras-chave:
Acidente Vascular Cerebral, Dor Neuropática, Hiperalgesia, Perceção da Dor, Sensibilização do Sistema Nervoso CentralResumo
Introdução: A dor pode ser uma sequela de um acidente vascular cerebral (AVC), sendo frequentemente subvalorizada, limitando a qualidade de vida do doente. Este trabalho teve como objetivo fazer uma revisão narrativa sobre a dor central (DC) pós-AVC, incluindo a sua definição, prevalência, apresentação clínica, diagnóstico, fisiopatologia e tratamento.
Métodos: Realizou-se uma pesquisa na PubMed® procurando artigos em Português ou Inglês, com texto completo, relatando investigação humana em adultos, utilizando os termos “central AND pain AND post stroke”. Foram incluídos 33 artigos nesta revisão narrativa.
Discussão: A DC pós-AVC é uma síndrome dolorosa neuropática consequente da agressão ao sistema nervoso central, caracterizada por dor e alterações sensitivas (como alodínia e hiperalgesia). Tem uma prevalência variável de 5% a 50% (no AVC talâmico), sendo frequentemente subdiagnosticada e subtratada. O seu tratamento inclui fármacos como antidepressivos e anticonvulsivantes, assim como uma abordagem não farmacológica adjuvante. A abordagem cirúrgica destina-se a casos refratários.
Conclusão: O tratamento da DC pós-AVC é desafiante e implica uma abordagem individualizada. Estudos futuros poderão esclarecer a fisiopatologia da DC, definir critérios de diagnóstico e reunir evidência que permita um tratamento mais eficaz.
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Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
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