1/31. Complex regional pain syndrome.Complex regional pain syndrome is a chronic pain syndrome that is often instigated by postoperative or post-traumatic events. The disease process can progress through three stages, the first of which tends to respond best to treatment. A review of the literature is presented, followed by a report of a patient who developed symptoms of complex regional pain syndrome following a water-skiing accident.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/31. Allergic reaction to spinal cord stimulator.OBJECTIVE: The objective was to report on the possibility of allergic reaction to the components of a spinal cord stimulator. DESIGN: We describe a severe allergic reaction after the insertion of a spinal cord stimulator in a patient with complex regional pain syndrome type 1. SETTING: The patient was being followed in an office-based pain management practice. PATIENT: The patient is a 41-year-old woman with complex regional pain syndrome type 1, posttrauma. Intervention: Insertion of a cervical and lumbar spinal cord stimulator. OUTCOME MEASURES: The outcome measures were a numerical scale of pain intensity and the ability to perform the activities of daily living. RESULTS: Adequate pain control complicated by allergic reaction. CONCLUSIONS: There exists a possibility that a patient may experience an allergic reaction to spinal cord stimulator components. Recognition of such contact sensitivity is important for physicians implanting such devices. patients may be misdiagnosed as having infections, which can delay appropriate management; definitive diagnosis can be confirmed with a patch test. Treatment consists of removal of such devices.- - - - - - - - - - ranking = 0.71428571428571keywords = pain (Clic here for more details about this article) |
3/31. Complex regional pain syndrome with selective emotional sudomotor failure.We report a patient with sympathetically maintained pain following a mild limb injury. Only emotional sudomotor failure was found in the painful limb. Thermoregulatory vasomotor function was intact. However, the patient had other target-specific sympathetic lesions, including thermoregulatory vasomotor failure in a different limb, not associated with pain. We hypothesize that the sympathetic failure preceded the symptoms and that the mild injury may have provoked collateral sprouting of emotional sudomotor fibres, coupling them with somatic sensory fibres to cause continuous pain.- - - - - - - - - - ranking = 1.1428571428571keywords = pain (Clic here for more details about this article) |
4/31. Complex regional pain syndrome in childhood: report of three cases.We describe three patients with the limb pain of complex regional pain syndrome (CRPS) in childhood with autonomic nervous system function involvement. Their autonomic nerve abnormality was non-invasively examined by means of laser doppler flowmetry (LDF) and a sympathetic skin response (SSR) test. In one it was resolved with physiotherapy, but the others needed epidural anesthesia for pain control. Though CRPS used to be recognized as a refractory disorder in adults, childhood cases have been found in recent years, generally having a better prognosis than adult ones. However, even in the children, the prognosis or responses to the same therapy vary, and there are progressive and refractory cases. CRPS should be considered as a differential diagnosis of unexplained persistent limb pain even in childhood for early and appropriate management.- - - - - - - - - - ranking = 1.1428571428571keywords = pain (Clic here for more details about this article) |
5/31. Complex regional pain syndrome (type I) after electrical injury: a case report of treatment with continuous epidural block.A 26-year-old man presented with severe complex regional pain syndrome type I of the affected limb after a work-related electrical injury. He suffered causalgia-like pain with no electrodiagnostic evidence of nerve injury. Early steroid and analgesic regimens did not adequately relieve these symptoms. His symptoms were temporarily relieved several times with stellate ganglion blocks. The patient underwent a cervical epidural block with a local anesthetic as well as a narcotic agonist over a 4-day period, which resulted in prompt, remarkable pain relief. Vocational rehabilitation was instituted as the pain subsided.- - - - - - - - - - ranking = 1.1428571428571keywords = pain (Clic here for more details about this article) |
6/31. Treatment of dystonic clenched fist with botulinum toxin.Fourteen patients with "dystonic clenched fist" (three with Corticobasal Ganglionic Degeneration, seven with Parkinson's disease, and four with Dystonic-Complex Regional Pain syndrome) were treated with botulinum toxin A (BTXA, Dysport). The muscles involved were identified by the hand posture and EMG activity recorded at rest and during active and passive flexion/extension movements of the finger and wrist. EMG was useful in distinguishing between muscle contraction and underlying contractures and to determine the dosage of BTX. All patients had some degree of flexion at the proximal metacarpophalangeal joints and required injections into the lumbricals. The response in patients depended on the severity of the deformity and the degree of contracture. All patients had significant benefit to pain, with accompanying muscle relaxation, and palmar infection, when present, was eradicated. Four patients with Parkinson's disease and one patient with dystonia-Complex Regional Pain syndrome obtained functional benefit.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
7/31. Chemical sympathectomy for neuropathic pain: does it work? Case report and systematic literature review.OBJECTIVE: To determine if chemical sympathectomy successfully reduces limb neuropathic pain. DESIGN: Systematic literature review of the effectiveness of phenol or alcohol sympathectomy for extremity neuropathic pain. PATIENT: A 29-year-old female with complex regional pain syndrome of both lower extremities after back surgery who was submitted to bilateral lumbar chemical sympathectomy. SEARCH STRATEGY: The Cochrane database of Systematic Reviews, the Cochrane Controlled Trials Register, medline, and EMBASE were systematically searched. OUTCOME MEASURES: (1) For the patient in question: spontaneous pain, allodynia, pinprick hyperalgesia, pressure evoked pain; (2) For the literature review: meaningful versus nonmeaningful pain relief based on degree and duration (>2 weeks) of pain relief. RESULTS: (1) The case reported experienced partial temporary relief of pain primarily related to selective modulation of allodynia, but not deep pain or pinprick hyperalgesia; (2) 44% of 66 patients in 13 studies that met the authors' inclusion criteria experienced meaningful pain relief. Whereas 19% experienced no meaningful relief, for the remaining 37% of the patients no conclusions regarding duration and degree of relief could be drawn due to poor reporting of outcomes. CONCLUSIONS: Based on the case reported and systematic literature review, chemical sympathectomy seems to have at best a temporary effect, limited to cutaneous allodynia. Despite the popularity of chemical sympatholysis, only few patients and poorly defined outcomes are reported in the literature, substantiating the need for well-designed studies on the effectiveness of the procedure.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
8/31. Complex regional pain syndrome: a report of two cases recalcitrant to usual treatment protocols.In this report the authors present a review of complex regional pain syndrome and two case reports of complex regional pain syndrome that were recalcitrant to the usual treatments. The first case presented is a middle-aged female who developed signs and symptoms of post-traumatic complex regional pain syndrome. The second case is a woman with a pre-existing history of complex regional pain syndrome whose condition worsened after surgery despite appropriate perioperative precautions. These cases are unique because in both cases an early diagnosis of complex regional pain syndrome was established, yet they were both resistant to the usual treatment protocols.- - - - - - - - - - ranking = 1.2857142857143keywords = pain (Clic here for more details about this article) |
9/31. Enigmatic pain referred to the teeth and jaws.A number of obscure syndromes can mimic dental or jaw pain in the absence of pathosis within these structures. This enigmatic dental pain includes conditions such as pretrigeminal neuralgia, complex regional pain syndrome, temporal tendinitis, and carotodynia. Each of these syndromes is described through a pertinent case report to illustrate appropriate diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
10/31. Complex Regional Pain syndrome in the ambulatory surgical care setting.This article provides an historical synopsis from the 17th century to the present regarding the disease process known as Complex Regional Pain syndrome (CRPS) Type I. An overview of the disease symptoms, plausible theories, and a review of the pain cycle, relief measures, and a case scenario are reported. The focus of pain blockade was chosen because this was the intervention used in this particular case. The author presents the holistic standpoint of the importance of incorporating complementary alternative medical practices (CAMP) to enhance a positive outcome for this client. OBJECTIVES: -Based on the content of this article, the reader should be able to (1) distinguish the main characteristic between CRPS Type I (reflex sympathetic dystrophy) and CRPS Type II (causalgia); (2) identify symptoms related to CRPS Type I; and (3) identify the stages of CRPS and state potential interventions used in the treatment of CRPS Type I.- - - - - - - - - - ranking = 0.28571428571429keywords = pain (Clic here for more details about this article) |
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