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Complex Regional Pain Syndrome (CRPS)

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https://www.readbyqxmd.com/read/29336203/aberrant-interactions-of-peripheral-measures-and-neurometabolites-with-lipids-in-complex-regional-pain-syndrome-using-magnetic-resonance-spectroscopy-a-pilot-study
#1
Ye-Ha Jung, Hyeonjin Kim, So Yeon Jeon, Jeong Min Kwon, Dasom Lee, Soo-Hee Choi, Do-Hyung Kang
Background The aim of this study was to assess peripheral measures and central metabolites associated with lipids using magnetic resonance spectroscopy. Results Twelve patients with complex regional pain syndrome (CRPS) and 11 healthy controls participated. Using magnetic resonance spectroscopy, we measured the levels of lipid 13a (Lip13a) and lipid 09 (Lip09) relative to total creatine (tCr) levels in the right and left thalamus. We found negative correlations of Lip13a/tCr in the right thalamus with red blood cells or neutrophils, but a positive correlation between Lip13a/tCr and lymphocytes in the controls...
January 2018: Molecular Pain
https://www.readbyqxmd.com/read/29320935/modified-dorsal-approach-in-the-management-of-lisfranc-injuries
#2
Andrew Philpott, Callum Lawford, Simon C Lau, Simon Chambers, Michael Bozin, Andrew Oppy
BACKGROUND: Open reduction and internal fixation of Lisfranc injuries has typically used multiple longitudinal incisions or a single transverse incision to approach the tarso-metatarsal joint (TMTJ). The incidence of wound-related complications is considerable. We describe a novel single-incision approach that utilizes subcutaneous windows to the medial TMTJ. METHODS: A retrospective review identified 150 patients who underwent open reduction and internal fixation for Lisfranc injuries, via the modified dorsal approach, at our center between January 2011 and June 2016...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29317053/fear-of-movement-modulates-the-feedforward-motor-control-of-the-affected-limb-in-complex-regional-pain-syndrome-crps-a-single-case-study
#3
Michihiro Osumi, Masahiko Sumitani, Yuko Otake, Shu Morioka
Pain-related fear can exacerbate physical disability and pathological pain in complex regional pain syndrome (CRPS) patients. We conducted a kinematic analysis of grasping movements with a pediatric patient suffering from CRPS in an upper limb to investigate how pain-related fear affects motor control. Using a three-dimensional measurement system, we recorded the patient's movement while grasping three vertical bars of different diameters (thin, middle, thick) with the affected and intact hands. We analyzed the maximum grasp distance between the thumb and the index finger (MGD), the peak velocity of the grasp movement (PV), and the time required for the finger opening phase (TOP) and closing phase (TCP)...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29303238/perioperative-management-of-a-parturient-with-complex-regional-pain-syndrome-for-elective-c-section
#4
Badie S Mansour, Gretchen Wienecke, Neeti Sadana, Pooya Pouralifazel, Alberto de Armendi
A 33 year-old female at 38 weeks gestation with a history of Complex Regional Pain Syndrome (CRPS) Type 1 of the upper extremities, diagnosed 13 years prior to this admission, was scheduled for an elective cesarean section (C-Section). She refused neuraxial anesthesia and requested general anesthesia. This abstract discusses the general anesthesia steps taken to pre-empt recurrence of CRPS symptoms.
April 2017: Journal of the Oklahoma State Medical Association
https://www.readbyqxmd.com/read/29302140/neurogenic-edema-from-complex-regional-pain-syndrome-resulting-in-fulminant-infection-necessitating-below-elbow-amputation
#5
Daniel P Carpenter, Reid W Draeger
We report a case of severe upper extremity complex regional pain syndrome type 1 (CRPS-1) and neurogenic edema that ultimately led to a medically necessary below-elbow amputation. The patient presented with a history of remote bilateral carpal tunnel release complicated by debilitating and recalcitrant bilateral CRPS-1. Following years of severe neurogenic edema of the left upper extremity, the patient had full-thickness skin sloughing on the dorsum of her hand due to massive edema. This subsequently led to maggot infestation of the soft tissues of the left hand ultimately necessitating amputation...
December 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29229431/altered-neurocognitive-processing-of-tactile-stimuli-in-patients-with-complex-regional-pain-syndrome-crps
#6
Anoop Kuttikat, Valdas Noreika, Srivas Chennu, Nicholas Shenker, Tristan Bekinschtein, Christopher A Brown
Chronic pain in CRPS has been linked to tactile misperceptions and deficits in somatotopic representation of the affected limb. Here, we identify altered cognitive processing of tactile stimuli in CRPS patients that we propose marks heterogeneity in tactile decision-making mechanisms. In a case-control design, we compared middle and late-latency somatosensory-evoked potentials (SEPs) in response to pseudo-randomised mechanical stimulation of the digits of both hands (including CRPS-affected and non-affected sides) between 13 CRPS patients and 13 matched healthy controls...
December 8, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29214172/migraine-and-complex-regional-pain-syndrome-a-case-referent-clinical-study
#7
Yohannes W Woldeamanuel, Corinne Cooley, Katharine Foley-Saldena, Robert P Cowan
We studied clinical phenotype differences between migraineurs with CRPS (Mig + CRPS) and those without (Mig - CRPS). Mig + CRPS cases and Mig - CRPS referents aged ≥18 years were enrolled. Diagnosis was made in accordance with International Classification of Headache Disorders-3 beta (ICHD-3 beta) for migraine and Budapest Criteria for CRPS. Migraines both with and without aura were included. A total of 70 Mig + CRPS cases (13% males, mean age 48 years) and 80 Mig - CRPS referents (17% males, mean age 51 years) were included...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29194871/are-you-better-a-multi-centre-study-of-patient-defined-recovery-from-complex-regional-pain-syndrome
#8
A Llewellyn, C S McCabe, Y Hibberd, P White, L Davies, J Marinus, R G S M Perez, I Thomassen, F Brunner, C Sontheim, F Birklein, T Schlereth, A Goebel, R Haigh, R Connett, C Maihöfner, L Knudsen, R N Harden, A Zyluk, D Shulman, H Small, F Gobeil, P Moskovitz
BACKGROUND: Complex Regional Pain Syndrome (CRPS) symptoms can significantly differ between patients, fluctuate over time, disappear or persist. This leads to problems in defining recovery and in evaluating the efficacy of therapeutic interventions. OBJECTIVES: To define recovery from the patients' perspective and better understand their priorities for treatment approaches. METHODS: Establishing an international consortium, we used a 2-Round Delphi-based study in eight countries across Europe and North America...
December 1, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29107167/does-temperature-increase-by-sympathetic-neurolysis-improve-pain-in-complex-regional-pain-syndrome-a-retrospective-cohort-study
#9
Sushmitha Dev, Yongjae Yoo, Ho-Jin Lee, Dong-Ho Kim, Yong-Chul Kim, Jee Youn Moon
BACKGROUND: Lumbar sympathetic neurolysis (LSN) is a treatment option for complex regional pain syndrome (CRPS). We examined whether LSN-related temperature changes are associated with clinical outcome and investigated relationships between the outcome of LSN and clinical variables in patients with CRPS-I. METHODS: We included 95 patients with CRPS-I affecting a single lower extremity, by the Budapest criteria, and who underwent LSN after successful lumbar sympathetic blocks, in this retrospective study...
January 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29091494/abductor-digiti-minimi-flap-for-vascularized-coverage-in-the-surgical-management-of-complex-regional-pain-syndrome-following-carpal-tunnel-release
#10
Kevin Cheung, Melissa A Klausmeyer, Jesse B Jupiter
BACKGROUND: The development of Complex Regional Pain Syndrome (CRPS) represents a potentially devastating complication following carpal tunnel release. In the presence of a suspected incomplete release of the transverse carpal ligament or direct injury to the median nerve, neurolysis as well as nerve coverage to prevent recurrent scar has been shown to be effective. METHODS: Retrospective chart review and telephone interview was conducted for patients who underwent abductor digiti minimi flap coverage and neurolysis of the median nerve for CRPS following carpal tunnel release...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29081703/factors-associated-with-complex-regional-pain-syndrome-in-surgically-treated-distal-radius-fracture
#11
Joel Ortiz-Romero, Ignacio Bermudez-Soto, Rubén Torres-González, Fernando Espinoza-Choque, Jesús Abraham Zazueta-Hernandez, José Manuel Perez-Atanasio
OBJECTIVE: The aim of this study was to identify factors associated with developing complex regional pain syndrome (CRPS) after surgical treatment for distal radius fracture (DRF). METHODS: This case-control study analyzed patients seen from January 2014 to January 2016. Results: In our sample of 249 patients, 4% developed CRPS. Associated factors were economic compensation via work disability (odds ratio [OR] 14.3), age (OR 9.38), associated fracture (OR 12.94), and level of impact (OR 6...
September 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/29064599/spinal-cord-stimulation-in-patients-with-complex-regional-pain-syndrome-a-possible-target-for-immunomodulation
#12
Nadia Kriek, Marco W J Schreurs, J George Groeneweg, Wim A Dik, Gilbert C H Tjiang, Ismail Gültuna, Dirk L Stronks, Frank J P M Huygen
OBJECTIVE: Complex regional pain syndrome (CRPS) is characterized by continued pain disproportional to the inciting event, sensory abnormalities, vasomotor and sudomotor disturbances, and motor and trophic changes. Inflammatory involvement has been demonstrated in past CRPS studies resulting in pain, swelling, and warmth. Currently, it is unknown whether spinal cord stimulation (SCS) has immunomodulatory properties. The aim of this study was to determine whether SCS has immunomodulatory properties in CRPS patients...
October 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29057068/case-report-percutaneous-electrical-neural-field-stimulation-in-two-cases-of-sympathetically-mediated-pain
#13
Lynn Fraser, Anna Woodbury
Background: Fibromyalgia and complex regional pain syndrome (CRPS) are both chronic pain syndromes with pathophysiologic mechanisms related to autonomic nervous system dysregulation and central sensitization.  Both syndromes are considered difficult to treat with conventional pain therapies. Case presentations: Here we describe a female veteran with fibromyalgia and a male veteran with CRPS, both of whom failed multiple pharmacologic, physical and psychological therapies for pain, but responded to percutaneous electrical neural field stimulation (PENFS) targeted at the auricular branches of the cranial nerves...
2017: F1000Research
https://www.readbyqxmd.com/read/29038061/structural-and-functional-brain-changes-at-early-and-late-stages-of-complex-regional-pain-syndrome
#14
Mahsa Shokouhi, Collin Clarke, Patricia Morley-Forster, Dwight E Moulin, Karen D Davis, Keith St Lawrence
Brain plasticity is demonstrated in complex regional pain syndrome (CRPS), although it is unclear how it modulates at different stages of CRPS. The observation that symptoms can progress over time suggests that the pattern of brain changes might also evolve. We measured structural and functional changes as well as sensorimotor integration at the early stage (ES) and late stage (LS) of CRPS. Twelve ES patients, 16 LS patients, and 16 age- and sex-matched controls were recruited. Gray matter (GM) volume was estimated using voxel-based morphometry...
October 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29037934/the-primary-diagnosis-and-the-coexisting-anxiety-disorders-have-no-impact-on-the-additional-surgical-procedure-after-spinal-cord-stimulators-implantation-an-analysis-of-11-029-patients
#15
Koji Tamai, Zorica Buser, Christopher Wang, Permsak Paholpak, Hiroaki Nakamura, Jeffrey C Wang, Patrick C Hsieh
Studies have demonstrated superior outcomes and cost effectiveness of the spinal cord stimulation (SCS) for the treatment of chronic pain syndromes such as failed back surgery syndrome (FBSS) or complex regional pain syndrome (CRPS). However, little is known about the impact of primary diagnosis or mental disorders on the revision rate. This is the Retrospective cohort study to analyze the reintervention rates based on the primary diagnosis or comorbid mental disorder. Data of the annual trends of SCS use, revision and removal rate of SCS and additional surgical rate after removal was collected and analyzed for patients undergoing SCS between 2007 and 2015, within a private insurance billing database...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29020809/fibromyalgia-as-a-predictor-of-complex-regional-pain-syndrome-after-distal-radius-fracture
#16
Marc D Lipman, Daniel E Hess, Brian C Werner, D Nicole Deal
BACKGROUND: Complex regional pain syndrome (CRPS) can be a devastating complication following extremity injury, but risk factors are not well understood. The purpose of this study was to investigate the association between fibromyalgia and the development of CRPS after distal radius fracture. METHODS: The PearlDiver Medicare database was queried using International Classification of Diseases, 9th Revision (ICD-9) and Current Procedural Terminology (CPT) codes for diagnoses and treatments of distal radius fractures...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28973211/low-dose-intravenous-immunoglobulin-treatment-for-long-standing-complex-regional-pain-syndrome-a-randomized-trial
#17
RANDOMIZED CONTROLLED TRIAL
Andreas Goebel, Jatinder Bisla, Roy Carganillo, Bernhard Frank, Rima Gupta, Joanna Kelly, Candy McCabe, Caroline Murphy, Nick Padfield, Ceri Phillips, Mark Sanders, Mick Serpell, Nick Shenker, Karim Shoukrey, Lynne Wyatt, Gareth Ambler
Background: Two small trials suggest that low-dose intravenous immunoglobulin (IVIg) may improve the symptoms of complex regional pain syndrome (CRPS), a rare posttraumatic pain condition. Objective: To confirm the efficacy of low-dose IVIg compared with placebo in reducing pain during a 6-week period in adult patients who had CRPS from 1 to 5 years. Design: 1:1 parallel, randomized, placebo-controlled, multicenter trial for 6 weeks, with an optional 6-week open extension...
October 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28971481/transcranial-magnetic-stimulation-studies-in-complex-regional-pain-syndrome-type-i-a-review
#18
REVIEW
R Nardone, F Brigo, Y Höller, L Sebastianelli, V Versace, L Saltuari, P Lochner, E Trinka
The sensory and motor cortical representation corresponding to the affected limb is altered in patients with complex regional pain syndrome (CRPS). Transcranial magnetic stimulation (TMS) represents a useful non-invasive approach for studying cortical physiology. If delivered repetitively, TMS can also modulate cortical excitability and induce long-lasting neuroplastic changes. In this review, we performed a systematic search of all studies using TMS to explore cortical excitability/plasticity and repetitive TMS (rTMS) for the treatment of CRPS...
October 3, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28961359/prevalence-and-cost-analysis-of-complex-regional-pain-syndrome-crps-a-role-for-neuromodulation
#19
Aladine A Elsamadicy, Siyun Yang, Amanda R Sergesketter, Bilal Ashraf, Lefko Charalambous, Hanna Kemeny, Tiffany Ejikeme, Xinru Ren, Promila Pagadala, Beth Parente, Jichun Xie, Shivanand P Lad
OBJECTIVE: The diagnosis and treatment of complex regional pain syndrome (CRPS) is challenging and there is a paucity of data describing its overall cost burden and quantifying its impact on the US healthcare system. The aim of this study was to assess the prevalence and healthcare utilization costs associated with CRPS. MATERIALS AND METHODS: A retrospective longitudinal study was performed using the Truven MarketScan® database to identify patients with a new indexed diagnosis of CRPS (Type I, II, or both) from 2001 to 2012...
September 29, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28960653/the-efficacy-and-safety-of-dorsal-root-ganglion-stimulation-as-a-treatment-for-neuropathic-pain-a-literature-review
#20
REVIEW
Conrad Harrison, Sarah Epton, Stana Bojanic, Alexander L Green, James J FitzGerald
OBJECTIVE: Dorsal root ganglion stimulation (DRGS) received its first regulatory approval (CE marking in Europe) in late 2011, and so its use is now almost six years old. Several thousand patients have already been treated, and a landmark trial in lower limb complex regional pain syndrome (CRPS) and causalgia has recently been published. METHODS: In this review we have summarized the literature to date on the use of DRGS in the treatment of neuropathic pain. RESULTS: The results so far are encouraging, with reports of successful use in treating a wide range of indications including postsurgical pain, CRPS, and phantom pain...
September 28, 2017: Neuromodulation: Journal of the International Neuromodulation Society
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