Identifikasi dan manajemen pada nyeri sentral pascastroke

Authors

DOI:

https://doi.org/10.25170/djm.v22i1.3943

Keywords:

nyeri neuropatik, nyeri sentral, nyeri sentral pascastroke, stroke

Abstract

Pendahuluan: Nyeri sentral pascastroke (NSPS) merupakan nyeri neuropatik sentral yang timbul setelah terjadinya stroke. Kondisi ini ditemukan pada 1-12% dari penderita stroke dan umumnya terjadi dalam 6 bulan pertama setelah terjadinya stroke. Nyeri yang ditimbulkan pada NSPS dapat mengakibatkan penurunan kualitas hidup, menghambat proses rehabilitasi, serta menimbulkan keterbatasan aktivitas dan interaksi sosial.

Tujuan: Sebagai bahan pembelajaran yang membahas mengenai diagnosis, manifestasi klinis, patofisiologi hingga tatalaksana dari NSPS.

Metode: Penulisan artikel ini menggunakan metode tinjauan naratif sebagai bagian dari studi literatur.

Diskusi: Pasien dengan NSPS datang dengan gejala sensoris yang bervariasi mulai dari sensasi terbakar, tertikam, hingga tersengat listrik. Adanya alodinia, disestesia dan hiperalgesia merupakan manifestasi tersering yang ditemukan pada penderita NSPS. Patofisiologi dari NSPS masih belum diketahui secara pasti, namun dikatakan adanya disinhibisi, sensitisasi sentral dan kerusakan pada jalur spinotalamikus dan talamus turut berperan dalam NSPS. Pendekatan tatalaksana pada NSPS dapat berupa terapi farmakologis maupun non farmakologis. Golongan antikonvulsan seperti gabapentin dan pregabalin, serta antidepresan seperti amitriptilin saat ini masih direkomendasikan sebagai terapi lini pertama. Sedangkan pada kasus NSPS yang refrakter, dapat digunakan terapi non farmakologis seperti deep brain stimulation dan motor cortex stimulation (MCS). Peripheral nerve block dalam beberapa laporan kasus juga memperlihatkan hasil yang menjanjikan, namun hal ini perlu ditelusuri lebih lanjut.

Kata Kunci: nyeri neuropatik, nyeri sentral, nyeri sentral pascastroke, stroke.

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References

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Published

2023-07-04

How to Cite

1.
Felicia, Jaya M. Identifikasi dan manajemen pada nyeri sentral pascastroke. DJM [Internet]. 2023 Jul. 4 [cited 2024 Nov. 5];22(1):69-75. Available from: https://ejournal.atmajaya.ac.id/index.php/damianus/article/view/3943
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