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John L Gillick, Jared B Cooper, Sateesh Babu, Kaushik Das, Raj Murali
BACKGROUND: Complex regional pain syndrome (CRPS), formerly referred to as reflex sympathetic dystrophy, is a pain syndrome characterized by severe pain, altered autonomic and motor function, and trophic changes. CRPS is usually associated with soft tissue injury or trauma. It has also been described as a rare complication of arterial access for angiography secondary to pseudoaneurysm formation. CASE DESCRIPTION: A 73-year-old woman underwent catheterization of the left brachial artery for angiography of the celiac artery...
August 2016: World Neurosurgery
Frederick R Dietz, Stephen P Compton
BACKGROUND: Chronic Regional Pain Syndrome type I (CRPSI) in children is a disorder of unknown etiology. No standard diagnostic criteria or treatment exists. Published treatment protocols are often time and resource intensive. Nonetheless, CRPSI is not rare and can be disabling. This reports the results of a simple and inexpensive treatment protocol involving no medicines, nerve blockades, physical therapy resources or referrals to pain specialists. The patient is instructed in a self-administered massage and mobilization program...
2015: Iowa Orthopaedic Journal
Jeanne E Hendrickson, Emma T Hendrickson, Eric A Gehrie, Davinder Sidhu, Gerd Wallukat, Ingolf Schimke, Christopher A Tormey
Reflex sympathetic dystrophy, also known as complex regional pain syndrome (CRPS), has recently been shown to be associated with autoantibodies against β2-adrenergic and muscarinic M2 receptors. In addition to pain and sudomotor/vasomotor symptoms, dysautonomia is also observed in a subset of CRPS patients. Despite its severity, there are few effective therapies for CRPS described to date. We report a case of a 14-year-old girl with CRPS of her right leg and dysautonomia (gastroparesis, postural tachycardia) refractory to multiple therapies, successfully treated with therapeutic plasma exchange (TPE) with albumin replacement...
August 2016: Journal of Clinical Apheresis
M Bussa, D Guttilla, M Lucia, A Mascaro, S Rinaldi
BACKGROUND: Complex regional pain syndrome type I (CRPS I), formerly known as reflex sympathetic dystrophy (RSD), is a chronic painful disorder that usually develops after a minor injury to a limb. This topical review gives a synopsis of CRPS I and discusses the current concepts of our understanding of CRPS I in adults, the diagnosis, and treatment options based on the limited evidence found in medical literature. CRPS I is a multifactorial disorder. Possible pathophysiological mechanisms of CRPS I are classic and neurogenic inflammation, and maladaptive neuroplasticity...
July 2015: Acta Anaesthesiologica Scandinavica
Kush Kumar
OBJECTIVES: A new method of interpretation of Three Phase Bone Scan (TPBS) scan based upon the normal physiological vascular endothelial related response. MATERIALS AND METHODS: Fifty cases of TPBS were evaluated. Thirteen were normal. In remaining 37 positive studies, 20 showed localized hyperemic response. All localized hyperemic responses except one with vascular endothelial dysfunction were without infection (95.0%). Infection could be ruled out in absence of generalized massive flow and pool response...
April 2015: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Jan Paul M Frölke, Robert T van Dongen, Henk van de Meent
Complex regional pain syndrome type 1 (CRPS-1) was identified in the Netherlands more than 30 years ago, but since then the arguments supporting this diagnosis have become weaker. Incidence has decreased, it is often not possible to make a definite diagnosis, the pathophysiology remains unclear and treatments are extremely diverse. Since the patient group is so heterogeneous, it is often unclear exactly which patients should be included. Disuse due to immobilization can give an identical clinical picture, including the inflammatory parameters that are seen in CRPS-1...
2015: Nederlands Tijdschrift Voor Geneeskunde
Andreas Böger
No abstract text is available yet for this article.
November 6, 2014: MMW Fortschritte der Medizin
Yeo Ok Kim, In Ji Kim, Myung Ha Yoon
Complex regional pain syndrome (CRPS) is a very complicated chronic pain disorder that has been classified into two types (I and II). Endothelin (ET) receptors are involved in pain conditions at the spinal level. We investigated the role of spinal ET receptors in CRPS. Chronic post-ischemia pain (CPIP) was induced in male Sprague-Dawley rats as a model for CRPS-I by placing a tourniquet (O-ring) at the ankle joint for 3h, and removing it to allow reperfusion. Ligation of L5 and L6 spinal nerves to induce neuropathic pain was performed as a model for CRPS-II...
January 1, 2015: Neuroscience Letters
Lino Becerra, Simona Sava, Laura E Simons, Athena M Drosos, Navil Sethna, Charles Berde, Alyssa A Lebel, David Borsook
Pediatric complex regional pain syndrome (P-CRPS) offers a unique model of chronic neuropathic pain as it either resolves spontaneously or through therapeutic interventions in most patients. Here we evaluated brain changes in well-characterized children and adolescents with P-CRPS by measuring resting state networks before and following a brief (median = 3 weeks) but intensive physical and psychological treatment program, and compared them to matched healthy controls. Differences in intrinsic brain networks were observed in P-CRPS compared to controls before treatment (disease state) with the most prominent differences in the fronto-parietal, salience, default mode, central executive, and sensorimotor networks...
2014: NeuroImage: Clinical
Young Hak Roh, Beom Koo Lee, Jung Ho Noh, Jong Ryoon Baek, Joo Han Oh, Hyun Sik Gong, Goo Hyun Baek
PURPOSE: Wrist fracture is considered a typical initiating trauma for complex regional pain syndrome type I (CRPS I). However, few studies have comprehensively evaluated factors associated with the occurrence of CRPS I after the surgical treatment of a distal radius fracture (DRF). This study evaluates the factors influencing the occurrence of CRPS I after the surgical treatment of a DRF. METHODS: A total of 477 patients with a DRF who had been treated surgically were enrolled in this prospective observational study...
December 2014: Archives of Orthopaedic and Trauma Surgery
Donald C Manning, Guillermo Alexander, Joseph C Arezzo, Alyse Cooper, R Norman Harden, Anne Louise Oaklander, Srinivasa N Raja, Richard Rauck, Robert Schwartzman
UNLABELLED: Complex regional pain syndrome (CRPS) is a potentially debilitating chronic pain syndrome with a poorly understood but likely neuroimmune/multifactorial pathophysiology associated with axonal injury. Based on the potential contribution of proinflammatory cytokines to CRPS pathogenesis and prior research with thalidomide, we investigated lenalidomide, a thalidomide derivative, for CRPS treatment. We conducted a phase II, randomized, double-blind, placebo-controlled study to evaluate the efficacy of oral lenalidomide 10 mg once daily in consenting patients with unilateral or bilateral CRPS type 1...
December 2014: Journal of Pain: Official Journal of the American Pain Society
Philipp Stude, Elena K Enax-Krumova, Melanie Lenz, Silke Lissek, Volkmar Nicolas, Soeren Peters, Amy Westermann, Martin Tegenthoff, Christoph Maier
BACKGROUND: Patients with complex regional pain syndrome type I (CRPS I) show a cortical reorganization with contralateral shrinkage of cortical maps in S1. The relevance of pain and disuse for the development and the maintenance of this shrinkage is unclear. OBJECTIVE: Aim of the study was to assess whether short-term pain relief induces changes in the cortical representation of the affected hand in patients with CRPS type I. STUDY DESIGN: Case series analysis of prospectively collected data...
September 2014: Pain Physician
Maria M Wertli, Alphons G H Kessels, Roberto S G M Perez, Lucas M Bachmann, Florian Brunner
OBJECTIVE: Guidelines for complex regional pain syndrome (CRPS) 1 advocate several substance classes to reduce pain and support physical rehabilitation, but guidance about which agent should be prioritized when designing a therapeutic regimen is not provided. Using a network meta-analytic approach, we examined the efficacy of all agent classes investigated in randomized clinical trials of CRPS 1 and provide a rank order of various substances stratified by length of illness duration. DESIGN: In this study a network meta-analysis was conducted...
September 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Yong Zhou, Xiaobin Yi, Wenxin Xing, Song Hu, Konstantin I Maslov, Lihong V Wang
Complex regional pain syndrome (CRPS) is a chronic pain syndrome that causes intractable pain, disability, and poor quality of life for patients. The etiology and pathophysiology of CRPS are still poorly understood. Due to a lack of proper diagnostic tools, the prognosis of CRPS is primarily based on clinical observation. The objective of this work is to evaluate a new imaging modality, photoacoustic microscopy (PAM), for assisting diagnoses and monitoring the progress and treatment outcome of CRPS. Blood vasculature and oxygen saturation (sO₂) were imaged by PAM from eight adult patients with CRPS-1...
August 2014: Journal of Biomedical Optics
J H Check, R Cohen
PURPOSE: To determine if treatment with sympathomimetic amines could improve the pain from complex regional pain disorder (CRPD) which was keeping a woman from trying to conceive her second child. MATERIALS AND METHODS: Dextroamphetamine sulfate was prescribed. RESULTS: Within a short length of time the woman's wrist pain considerably improved to the point that she is ready to try in vitro fertilization once again to have a second baby. CONCLUSIONS: Though sympathomimetic amines are used by some reproductive endocrinologists for unexplained infertility and unexplained recurrent miscarriages, the most common use by the gynecologist is for pelvic pain...
2014: Clinical and Experimental Obstetrics & Gynecology
Porin Perić
In 1994, a consensus group of experts gathered by the International Association for the Study of Pain (IASP) agreed on new diagnostic criteria for the reflex sympathetic dystrophy (RSD) and causalgia, and renamed them complex regional pain syndrome (CRPS) types I and II, respectively. CRPS is a complex pathophysiological entity characterised by pain, trophic and vasomotoric changes, limited function of affected body part and relatively fast development of osteoporosis of affected region. We described possible pathophysiological mechanisms which caused the pain, clinical presentation of the disease and treatment which includes all available pharmacological modalities as well as interventional procedures...
2013: Reumatizam
Massimo Varenna, Silvano Adami, Luigi Sinigaglia
Complex Regional Pain syndrome type I (CRPS-I) is a disease characterised by extreme pain for which no gold-standard treatment exists to date. In recent years a possible role for bisphosphonates in the treatment of CRPS-I has been proposed. These drugs were first used for their effect in decreasing pain in bone diseases in which bisphosphonates act through their antiosteoclastic properties (metastatic disease, Paget disease, myeloma). In CRPS-I, enhanced osteoclastic activity has never clearly been demonstrated and the benefit shown is possibly exerted by different mechanisms of action...
July 2014: Clinical and Experimental Rheumatology
Karen Hind, Mark I Johnson
INTRODUCTION: Dual-energy X-ray absorptiometry is rarely utilized in the clinical care of patients with complex regional pain syndrome, but may be useful for the non-invasive determination of regional bone fragility and fracture risk, as well as muscular atrophy and regional body composition. This is the first report in the literature of complex regional pain syndrome and musculoskeletal co-morbidities in an athlete, and is the first to focus on dual-energy X-ray absorptiometry for the clinical assessment of complex regional pain syndrome...
2014: Journal of Medical Case Reports
Eyal Zur
The case report discussed in this article illustrates the painful endeavor of a patient who suffered from severe peripheral neuropathic pain and the to-and-from treatment adjustments that are needed before an optimal grade of pain control and an acceptable quality of life could be achieved. The next to optimal treatment was obtained by meticulously adjusting drugs and combining systemic drugs with topical ones. Compounding pharmacists play an important role in offering potent topical preparations that give an important analgesic added value to complex treatments...
January 2014: International Journal of Pharmaceutical Compounding
Hitoshi Hirata
Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy, is attracting more public attention in Japan which is likely a result of the recent upsurge in lawsuits filed against medical institutes. A recent court ruling over a case of injection-needlestick-injury induced CRPS has touched off serious debates among both medical practitioners and legal professionals. Although the court rejected the plaintiff's claims, the high court admitted them in view of the evidence and the entire pleadings and ordered the defendant to pay compensation...
2014: Hand Surgery
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