Pain after stroke is commonly reported but often incompletely managed, which prevents optimal recovery. This situation occurs in part because of the esoteric nature of poststroke pain and its limited presence in current discussions of stroke management. The major specific afflictions that affect patients with stroke who experience pain include central poststroke pain, complex regional pain syndrome, and pain associated with spasticity and shoulder subluxation. Each disorder carries its own intricacies that require specific approaches to treatment and understanding. This review aims to present and clarify the major pain syndromes that affect patients who have experienced a stroke in order to aid in their diagnosis and treatment.

Anticollapsin-responsive mediator protein 5 (CRMP-5) IgG is an antibody generally associated with small-cell lung cancer, which is known to cause paraneoplastic neurological syndromes, including encephalitis, myelitis and neuropathy. HIV escape is a phenomenon in which a patient with low or undetectable levels of HIV RNA in plasma is found to have elevated levels in cerebrospinal fluid (CSF). We present a case of a 58-year-old HIV-positive woman with undetectable plasma viral load who developed a subacute flaccid paraparesis. Over the course of 4 months, she had a broad inflammatory and infectious workup that was unrevealing until repeat imaging showed an inflammatory myelitis. Workup was notable for elevated HIV RNA copies in CSF, as well as anti-CRMP-5 autoantibodies in serum. Despite changing her antiretroviral therapy and multiple modalities of immunomodulation, the patient failed to respond adequately to treatment. This case illustrates a complex clinical picture with a unique presentation of anti-CRMP-5 myelitis.