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236 A case of complex regional pain syndrome resolved by temporary spinal cord stimulation
S104
Poster Presentations / Postherpetic Neuraligia, CRPS / European Journal of Pain 11(S1) (2007) S59–S207
Results. Patients with CRPS differ significantly from healthies in nearly all parameters. However, patients with neuralgia after nerve injury or with psychosomatic diseases also demonstrated significant side differences. In patients with CRPS the temperature changed significantly more often in a direction other than contralateral (a-synchronicity) and the frequency of oscillations was significantly different on the affected side. Using a summ-score (four variables: Asynchr, Qoszill, a, r2), CRPS could be diagnosed with a specifity of 78% vs. patients with other painful diseases and 90% vs. healthies (sensitivity: 75%, respectively 91%). Conclusions. The assessment of mean side differences of skin temperature is not appropriate for diagnosing CRPS in patients with limb pain. A score characterizing the dynamics of the skin temperature is a new diagnostic tool, particularly for patients with CRPS of the upper extremity.
Table 1
Reference Wasner et al. (2002). Pain, 98(1–2), 19. doi:10.1016/j.ejpain.2007.03.250
236 A CASE OF COMPLEX REGIONAL PAIN SYNDROME RESOLVED BY TEMPORARY SPINAL CORD STIMULATION K.R. Lee *, M.K. Kim, H.S. Lee, S.M. Choi, M.S. Park, B.C. Kim, K.H. Cho Department of Neurology, Chonnam National University Hospital, Gwang-Ju, South Korea Background. Disturbances of sensory, motor and autonomic function are the characteristics of the complex regional pain syndrome (CRPS). Conventional pain medication, physical therapy, sympathetic blocks and transcutaneous electrical nerve stimulation have been used to reduce the intensity of pain of CRPS. In some patients, spinal cord stimulation showed favorable results. Case. We would like to report a 29-year-old patient with burning pain and allodynia in right leg. She had a recent history of repeatedly burning pain at her leg for 2 years. These symptoms were more aggravated after traffic accident 1 year ago. Burning pain and edema of right leg was resolved completely after temporary spinal cord stimulation. Now, she is free from pain for 10 months after spinal cord stimulation. Conclusions. CRPS is resolved by temporary spinal cord stimulation.
doi:10.1016/j.ejpain.2007.03.251
237 IMAGINED REGROWTH: NORMALISING THE MENTAL REPRESENTATION OF A CRPS ARM J.S Lewis *,a, D.J Peters b a
Department of Rheumatology, The Royal National Hospital for Rheumatic Diseases, Bath, UK b Department of Rheumatology and Hand Trauma, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, Devon, UK Background and aims. Body perception disturbance in CRPS is described by patients as a perceptual distortion in size, weight and shape of the affected limb. Clinically, when describing a mental image of the affected limb with their eyes closed, patients report portions of that limb
Poster Presentations / Postherpetic Neuraligia, CRPS / European Journal of Pain 11(S1) (2007) S59–S207
Results. Patients with CRPS differ significantly from healthies in nearly all parameters. However, patients with neuralgia after nerve injury or with psychosomatic diseases also demonstrated significant side differences. In patients with CRPS the temperature changed significantly more often in a direction other than contralateral (a-synchronicity) and the frequency of oscillations was significantly different on the affected side. Using a summ-score (four variables: Asynchr, Qoszill, a, r2), CRPS could be diagnosed with a specifity of 78% vs. patients with other painful diseases and 90% vs. healthies (sensitivity: 75%, respectively 91%). Conclusions. The assessment of mean side differences of skin temperature is not appropriate for diagnosing CRPS in patients with limb pain. A score characterizing the dynamics of the skin temperature is a new diagnostic tool, particularly for patients with CRPS of the upper extremity.
Table 1
Reference Wasner et al. (2002). Pain, 98(1–2), 19. doi:10.1016/j.ejpain.2007.03.250
236 A CASE OF COMPLEX REGIONAL PAIN SYNDROME RESOLVED BY TEMPORARY SPINAL CORD STIMULATION K.R. Lee *, M.K. Kim, H.S. Lee, S.M. Choi, M.S. Park, B.C. Kim, K.H. Cho Department of Neurology, Chonnam National University Hospital, Gwang-Ju, South Korea Background. Disturbances of sensory, motor and autonomic function are the characteristics of the complex regional pain syndrome (CRPS). Conventional pain medication, physical therapy, sympathetic blocks and transcutaneous electrical nerve stimulation have been used to reduce the intensity of pain of CRPS. In some patients, spinal cord stimulation showed favorable results. Case. We would like to report a 29-year-old patient with burning pain and allodynia in right leg. She had a recent history of repeatedly burning pain at her leg for 2 years. These symptoms were more aggravated after traffic accident 1 year ago. Burning pain and edema of right leg was resolved completely after temporary spinal cord stimulation. Now, she is free from pain for 10 months after spinal cord stimulation. Conclusions. CRPS is resolved by temporary spinal cord stimulation.
doi:10.1016/j.ejpain.2007.03.251
237 IMAGINED REGROWTH: NORMALISING THE MENTAL REPRESENTATION OF A CRPS ARM J.S Lewis *,a, D.J Peters b a
Department of Rheumatology, The Royal National Hospital for Rheumatic Diseases, Bath, UK b Department of Rheumatology and Hand Trauma, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, Devon, UK Background and aims. Body perception disturbance in CRPS is described by patients as a perceptual distortion in size, weight and shape of the affected limb. Clinically, when describing a mental image of the affected limb with their eyes closed, patients report portions of that limb