d Prince of Wales Medical Research Institute and the

University of New South Wales, Sydney, NSW, Australia

Background and aims. Over the past decade, there hasbeen growing interest in the role of the motor system inpain processing. The aim of this investigation was todetermine the effects of movement imagery on the levelof on-going pain in spinal cord injury (SCI) patientswith neuropathic pain.

Methods. We compared the effects of imagined rightankle plantarflexion and dorsiflexion on perceived painintensity in SCI subjects with clinically complete (ASIAA) thoracic injuries (T2–T10), with (n = 7) and without(n = 7) neuropathic pain below the level of their injury.A recorded engine sound was used to assist in the timingof movements. Imagined movements were rehearsed forone week prior to assessment.

Results. In every SCI subject with neuropathic pain,ankle movement imagery resulted in a significantincrease in pain intensity. In no SCI subject did eitherattention directed towards the right ankle or movementimagery involving the right wrist evoke any change inpain or non-painful intensity or distribution. In eachSCI subject without neuropathic pain, but with phantomsensations, ankle movement imagery did not evoke pain,but instead evoked a significant increase in the intensityof perceived phantom sensation. One patient reportednew unpleasant phantom sensation during imagery.

Conclusions. In contrast to studies employing motorcortex stimulation which typically reduces pain, move-ment imagery significantly increases neuropathic painand phantom sensations in patients with SCI. Further-more, movement imagery can evoke unpleasant phan-tom sensations in SCI patients without on-goingphantom sensation and/or pain.

doi:10.1016/j.ejpain.2007.03.330

316INFLUENCE OF AGE ON CENTRAL POST-

STROKE PAIN

M. Zaletel *, B. Zvan, J. Kobal

University Medical Centre, Department of Neurology,

Ljubljana, Slovenia

Introduction. Central post-stroke pain (CPSP) is asyndrome characterized by sensory disturbances andneuropathic pain. Functional disturbances such asdepression, anxiety and sleep disturbances may sig-nificantly have an influence on neuropathic painexpression. The contribution of age in CSPS is notclear.

Methods. We randomly investigated 297 patients(mean age 72 ± 5.4 years) with first-time stroke over a

1-year period. Patients were evaluated 6 months and12 months following stroke onset. Pain was assessedusing a visual analogue scale ranging from zero mm(no pain) to 100 mm. Using the scale, zero was definedas no pain, 10–30 as mild pain, and 40–100 as moderateto severe pain. Depression was evaluated on a depres-sion scale. Logistic regression was used to analyse theassociations.

Results. Twenty-seven (9.2%) patients developedCPSP. Factors significantly associated with an increasedlikelihood of having moderate to severe pain includedyounger age and higher scores on a depression scale(p < 0.01). Pain was reported as constantly present in37% patients, and it disturbed sleep in 67% patients.

Conclusions. We concluded that CPSP was associatedwith younger age stroke patients. Depression is animportant factor in CPSP.

doi:10.1016/j.ejpain.2007.03.331

Poster Session 2: Clinical – Case Studies

317CHRONIC PAIN AFTER OPEN REPAIR OF

INGUINAL HERNIA

M. Kokolaki, A. Bairaktari *, P. Kamperi,

M. Vafiadou

Department of Anesthesia and Pain Clinic, ‘‘Sismano-

glion’’ General Hospital, Athens, Greece

We present the management of four patients that suf-fered from severe chronic pain after open repair ofinguinal hernia.

Material. Four male patients, aged 55–70 years oldcomplained of severe paroxysmal pain (VAS: 7–10)one month after open repair of inguinal hernia. Thepain was described as ‘‘sharp’’, ‘‘stabbing’’ and ‘‘elec-tric shock-like’’ along the line of the incision. Therewas not any hyperalgesia or allodynia. Surgical exam-ination excluded any surgically correctable pathologysuch as hernia recurrence. Two of the patientsreceived gabapentin (1200 mg/day) for two months.The pain was relieved and never reappeared. Thethird patient was reoperated in an attempt to identifythe cause of the pain at surgery and correct the prob-lem. Pain continued to exist after reoperation and thepatient received gabapentin (1200 mg/day) and ami-triptyline (50 mg/day) for three months. The fourthpatient although he received many kinds of treatment(gabapentin, amitriptylline, venlafaxine, ketamine,patch lidoderm, NSAID, infiltrations with local anes-thetics along the incision line) was partially relieved(VAS: 5).

S140 Poster Presentations / Clinical – Case Studies / European Journal of Pain 11(S1) (2007) S59–S207