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Complex regional pain syndrom

Frank Birklein, Seena K Ajit, Andreas Goebel, Roberto S G M Perez, Claudia Sommer
Complex regional pain syndrome (CRPS) is a pain condition that usually affects a single limb, often following an injury. The underlying pathophysiology seems to be complex and probably varies between patients. Clinical diagnosis is based on internationally agreed-upon criteria, which consider the reported symptoms, presence of signs and exclusion of alternative causes. Research into CRPS biomarkers to support patient stratification and improve diagnostic certainty is an important scientific focus, and recent progress in this area provides an opportunity for an up-to-date topical review of measurable disease-predictive, diagnostic and prognostic parameters...
March 16, 2018: Nature Reviews. Neurology
Michael J Moskal
No abstract text is available yet for this article.
April 2018: Clinical Orthopaedics and related Research
Marc Sorel, Jacques-Christian Beatrix, Blanche Locko, Catherine Armessen, Anne-Marie Domec, Otilia Lecompte, Sofiane Boucheneb, Benoit Harache, Jacques Robert, Jean-Pascal Lefaucheur
OBJECTIVES: The efficacy of ketamine in relieving complex regional pain syndrome (CRPS) lacks predictive factors. The value of three-phase bone scintigraphy (TPBS) was assessed or this purpose. METHODS: TPBS was performed in 105 patients with unilateral, focal CRPS of type 1 before 5 days of ketamine infusions. Tracer uptake was measured in the region of interest concerned by CRPS and the contralateral homologous region. For the three scintigraphic phases (vascular, tissular, and bone phases), an asymmetry ratio of fixation was calculated between the affected and the unaffected sides (VPr, TPr, and BPr)...
March 13, 2018: Clinical Journal of Pain
Jijun Xu, Christopher Herndon, Samantha Anderson, Philip Getson, Victor Foorsov, Peter Moskovitz, R Norm Harden
Objective: To find and reach a consensus on the usage of ketamine in the treatment of complex regional pain syndrome and to determine a reference protocol for future studies. Design: Three hundred fifty-one medical professionals participated in our survey on practice procedures, with 104 respondents providing information on their usage of ketamine for treating the pain associated with complex regional pain syndrome. Respondents answered questions about inpatient treatment, outpatient treatment, children vs adults, safety, and basic demographic information...
March 9, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Sean C Maguire, Christina A Fleming, Gavin O'Brien, Gerald McGreal
BACKGROUND: Lumbar sympthectomy (LS) was traditionally performed for intermittent claudication but is now eclipsed by revascularisation for that indication. However, it retains a role in the management of critical limb ischaemia and other conditions causing lower limb pain with or without ischaemia. We report the role of LS in modern surgical practice when revascularisation and pain management options have been exhausted. METHODS: A medical chart review was performed on all patients who underwent LS in our unit from 2005 to 2016 (inclusive)...
March 7, 2018: Irish Journal of Medical Science
Mark Gaertner, Jiang-Ti Kong, Kristen H Scherrer, Alyssa Foote, Sean Mackey, Kevin A Johnson
INTRODUCTION: Complex Regional Pain Syndrome (CRPS), a rare and severe chronic pain condition, often responds poorly to existing treatments. Previous studies demonstrated Transcranial Magnetic Stimulation (TMS) provided short-term pain relief for upper extremity CRPS. METHODS: Building on previous methodologies, we employed a TMS protocol that may lead to significant pain relief for upper and lower extremity CRPS in a nonrandomized open label pilot trial involving 21 participants...
March 4, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Silvia Duong, Daniela Bravo, Keith J Todd, Roderick J Finlayson, De Q Tran
PURPOSE: Although multiple treatments have been advocated for complex regional pain syndrome (CRPS), the levels of supportive evidence are variable and sometimes limited. The purpose of this updated review is to provide a critical analysis of the evidence pertaining to the treatment of CRPS derived from recent randomized-controlled trials (RCTs). SOURCE: The MEDLINE, EMBASE, Psychinfo, and CINAHL databases were searched to identify relevant RCTs conducted on human subjects and published in English between 1 May 2009 and 24 August 2017...
February 28, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Anthony L Logli, Brian J Bear, Edric G Schwartz, Kenneth J Korcek, Brian J Foster
PURPOSE: To determine if any significant differences exist in patient-reported or clinical outcomes among 3 different postoperative orthotic regimens: no orthosis, removable orthosis, and plaster nonremovable orthosis-following miniopen carpal tunnel release (CTR) surgery for symptomatic isolated carpal tunnel syndrome. METHODS: A total of 249 patients received a miniopen CTR and were subsequently randomized into 1 of 3 orthotic regimens: 80, no orthosis; 83, removable orthosis; and 86, nonremovable orthosis-to be removed at the first postoperative visit 10 to 14 days later...
February 24, 2018: Journal of Hand Surgery
Nagy Mekhail, Ogi Visnjevac, Gerges Azer, Diana Sue Mehanny, Priya Agrawal, Victor Foorsov
To assess the efficacy of spinal cord stimulation (SCS) for each indication, one must critically assess each specific clinical outcome to identify outcomes that benefit from SCS therapy. To date, a comprehensive review of clinically relevant outcome-specific evidence regarding SCS has not been published. We aimed to assess all randomized controlled trials from the world literature for the purpose of evaluating the clinical outcome-specific efficacy of SCS for the following outcomes: perceived pain relief or change pain score, quality of life, functional status, psychological impact, analgesic medication utilization, patient satisfaction, and health care cost and utilization...
February 23, 2018: Regional Anesthesia and Pain Medicine
Tara L Packham, Joy C MacDermid, Susan L Michlovitz, Norman Buckley
BACKGROUND: Complex regional pain syndrome (CRPS) is a perplexing neurological condition, and persons with CRPS experience substantial loss of daily roles and activities. A condition-specific measure is being developed to evaluate CRPS. PURPOSE: We describe the use of cognitive interviews to examine content validity of this patient-reported outcome measure for CRPS. METHOD: Interviews with 44 persons with CRPS were analyzed to identify problems with wording and support content validation...
January 1, 2018: Canadian Journal of Occupational Therapy. Revue Canadienne D'ergothérapie
Koji Abe, Toshiyasu Nakamura, Eiko Yamabe, Koichi Oshio, Takeshi Miyamoto, Masaya Nakamura, Morio Matsumoto, Kazuki Sato
Patients with complex regional pain syndrome (CRPS) exhibit diverse symptoms, such as neuropathic pain, allodynia, local edema and skin color changes in the affected lesion. Although nerve injury may cause CRPS, pathophysiological mechanisms underlying the syndrome are unclear, and local edema, a characteristic of CRPS, has not been evaluated quantitatively for technical reasons. Here, using a rat spinal nerve ligation-induced CRPS model, we show that edematous changes in gastrocnemius muscle can be detected quantitatively by diffusion magnetic resonance imaging (MRI)...
2018: PloS One
Tara Packham, Janet Holly
STUDY DESIGN: Narrative review. INTRODUCTION: There are a variety of treatments with demonstrated effectiveness for the management of complex regional pain syndrome (CRPS). However given the variability in symptom presentation in this population, therapists may be unsure what treatments would be most effective for individual clients. PURPOSE OF THE STUDY: To present a brief synthesis of the literature and propose a rehabilitation version of a mechanism-specific management algorithm to guide personalized treatment of CRPS...
February 13, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Priscilla G Wittkopf, Mark I Johnson
The consequences of chronic pain and associated disabilities to the patient and to the health care system are well known. Medication is often the first treatment of choice for chronic pain, although side effects and high costs restrict long-term use. Inexpensive, safe and easy to self-administer non-pharmacological therapies, such as mirror therapy, are recommended as adjuncts to pain treatment. The purpose of this review is to describe the principles of use of mirror therapy so it can be incorporated into a health care delivery...
November 2017: Revista da Associação Médica Brasileira
Claudia Sommer, Mathias Leinders, Nurcan Üçeyler
Peripheral nerve injuries and diseases often lead to pain persisting beyond the resolution of damage, indicating an active disease-promoting process, which may result in chronic pain. This is regarded as a maladaptive mechanism resulting from neuroinflammation that originally serves to promote regeneration and healing. Knowledge on these physiological and pathophysiological processes has accumulated over the last few decades and has started to yield potential therapeutic targets. Key players are macrophages, T-lymphocytes, cytokines, and chemokines...
March 2018: Pain
Jennifer Chu, Frans Bruyninckx, Duncan V Neuhauser
Introduction: Favourable pain relief results on evoking autonomous twitches at myofascial trigger points with Electrical Twitch Obtaining Intramuscular Stimulation (ETOIMS). Aim: To document autonomic nervous system (ANS) dysfunction in Complex Regional Pain Syndrome (CRPS) from blood pressure (BP) and pulse/heart rate changes with ETOIMS. Methods and materials: A patient with persistent pain regularly received serial ETOIMS sessions of 60, 90, 120 or ≥150 min over 24 months...
July 2017: BMJ Innovations
SuHwan Shin, Seung Gyeong Jang, KyeongTae Min, Won Lee, So Yoon Kim
BACKGROUND: Complex regional pain syndrome (CRPS) involves severe pain and it is difficult to identify the exact cause or pathogenesis. Therefore, there are controversies regarding legal issues related to the establishment of damage in medical malpractice lawsuits involving CRPS. This study aimed to analyze malpractice lawsuits involving CRPS, which occurred after the disputed medical treatment, to provide information on the courts' opinion and characteristics of the cases. METHODS: This study analyzed 23 lawsuit judgments involving CRPS that were sentenced from 2005 to 2015...
February 26, 2018: Journal of Korean Medical Science
Karen Frei, Daniel D Truong, Stanley Fahn, Joseph Jankovic, Robert A Hauser
Since the original description of side effects of neuroleptics, different terminologies and definitions for tardive dyskinesia (TD) and tardive syndrome (TS) have been used by different authors, and often these two terms have been used interchangeably. This paper proposes a nosology designed to define and clarify various terms and phenomenologies within the TS spectrum. We propose to use the term tardive dyskinesia to refer to the original description of repetitive and complex oral-buccal-lingual (OBL) movements, as well as to the analogous repetitive movements that can appear in the limbs, trunk, or pelvis...
February 6, 2018: Journal of the Neurological Sciences
Karlijn Barnhoorn, J Bart Staal, Robert Tm van Dongen, Jan Paul M Frölke, Frank P Klomp, Henk van de Meent, Eddy Adang, Maria Wg Nijhuis-van der Sanden
OBJECTIVE: To analyze cost-effectiveness of Pain Exposure Physical Therapy compared to conventional treatment alongside a randomized controlled trial (NCT00817128) in patients with complex regional pain syndrome type 1, where no clinical difference was shown between the two groups in an intention-to-treat analysis. DESIGN: Randomized controlled trial with 9 months follow-up. SETTING: Patients were recruited from hospitals and general practitioners in the region around a university hospital...
February 1, 2018: Clinical Rehabilitation
Dominic Hegarty
No abstract text is available yet for this article.
January 2018: Pain Reports (Baltimore, Md.)
M Wittayer, V Dimova, F Birklein, T Schlereth
Neglect-like symptoms (NLS) are frequently observed in CRPS. The clinical meaning of NLS, however, is largely unknown. Therefore, this study sets out to assess the importance of NLS for patient outcome and to explore their clinical correlates. We assessed NLS in a group of 53 CRPS patients and compared the results to 28 healthy volunteers. In order to define the origin of the NLS reports, we tested the subjective visual midline (SVM), performed a limb-laterality recognition test (LLT), and quantitative sensory testing (QST)...
February 5, 2018: Pain
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