Focal pruritus may have a neurological cause. According to the underlying mechanism, two categories of central itch have been distinguished, neuropathic and neurogenic pruritus. We here describe a patient with Brown-Séquard syndrome related to unilateral damage of the spinal cord. The patient progressively developed neuropathic pruritus with chronic prurigo lesions showing strictly hemicorporal distribution. The patient was given pregabalin, an analogue of the neurotransmitter gamma-aminobutyric acid,with significant improvement. Our observation of chronic prurigo with hemicorporal involvement is unique. It underscores the importance of a detailed neurological examination in case of persistent localized itch and further supports the idea that chronic prurigo reflects a neurological problem in a subset of affected patients. Antiepileptic drugs should be considered not only for neuropathic pain, but also for neuropathic itch.