Atypical Central Neuropathic Pain Following Stroke Presenting With Distal Movement-Evoked Shoulder Pain: A Case Report

Abstract

This case report describes a unique presentation of central neuropathic pain (CNP) in a Chinese male in his 40s, following a large right basal ganglia hemorrhage with extension into the right middle cerebral artery (MCA) territory, characterized by left shoulder pain reproducibly triggered by passive wrist and finger extension. The report outlines the sequential treatment approach implemented for pain management. Although spasticity and shoulder pain are common sequelae of stroke, this case highlights the importance of considering central neuropathic mechanisms in patients with atypical or refractory symptoms. It also underscores the heterogeneity of CNP following stroke and the need for heightened clinical awareness of this condition.