Complete relief of CRPS-associated pain during magnesium infusion in a patient with postpartum preeclampsia

2019 ◽  
Vol 44 (4) ◽  
pp. 521-523 ◽  
Author(s):  
Jonathan A Niconchuk ◽  
Michael G Richardson
Keyword(s):  
Preterm Labor ◽  
Case Reports ◽  
Pain Syndrome ◽  
Pregnant Patient ◽  
Complete Relief ◽  
Intravenous Magnesium ◽  
Chronic Regional Pain Syndrome ◽  
Patient Reported ◽  
Pain Symptoms ◽  
Magnesium Therapy

A pregnant patient with chronic regional pain syndrome (CRPS) and indwelling spinal cord stimulator presented with twin gestation for induction of preterm labor due to preeclampsia. Intravenous magnesium was initiated and a lumbar epidural catheter was placed uneventfully for labor analgesia. The patient reported complete relief of her CRPS-associated pain during and for 24 hours after delivery, while receiving intravenous magnesium, with her pain symptoms returning shortly after discontinuing magnesium. To our knowledge, there are no case reports that describe CRPS-associated pain relief while on peripartum magnesium therapy.

scholarly journals The effectiveness of therapeutic massage in lumbar and cervical spine pain syndrome – case study

2015 ◽  
Vol 9 (2) ◽  
pp. 24-27
Author(s):  
Iwona Wilk
Keyword(s):  
Cervical Spine ◽  
Lower Limb ◽  
Pain Syndrome ◽  
Lymphatic Drainage ◽  
Lower Limbs ◽  
Substantial Part ◽  
Therapeutic Massage ◽  
Spine Pain ◽  
Patient Reported ◽  
Pain Symptoms

Background: The spine pain syndrome is a common problem in a substantial part of the population which currently affects younger and younger people. The underlying risk factors include the character of work, sedentary lifestyle and lack of physical activity. Except for complex physiotherapy which should be applied during treatment, a lifestyle prophylaxis also seems to be a key factor. Aim of the study: The aim of this study was to present the possibility to use the classical and therapeutic massage of the back, and a lymphatic drainage of lower limbs in case of the lumbar and cervical spine pain syndrome accompaniedby the lower limb swelling. Material and methods: A young woman with the lumbar and cervical spine pain syndrome received a 55-minute lymphatic drainage (four sessions), a 30-minute classical massage (four sessions) and a 45-minute therapeutic massage (two sessions). All the procedures were performed every two days. Results: After the application of all kinds of the massage, selected individually to current symptoms and needs of the patient, the pain in the area of the spine was relieved. After the therapy the pressure pain in the back muscles such as: latissimus dorsi (lats), trapezius (traps) and spinal erectors was also decreased. The swelling in the area of the lower limb was reduced and the patient reported general decrease of pain. Conclusions: A massage may constitute an effective anti-pain therapy in case of the lumbar and cervical spine pain syndrome. Combined with educating patients about proper motor habits might prevent similar pain symptoms in the future.

Abstract 326: Postural Orthostatic Tachycardia Syndrome and its Associated Chronic Pain Symptoms

2015 ◽  
Vol 117 (suppl_1) ◽  
Author(s):  
Chandralekha Ashangari ◽  
Amer Suleman
Keyword(s):  
Chronic Pain ◽  
Medical Records ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
The Body ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Chronic Regional Pain Syndrome ◽  
High Prevalence ◽  
Pain Symptoms ◽  
Very High

Background and Purpose: The Postural Orthostatic Tachycardia Syndrome (POTS) affects primarily young women. POTS is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. The symptoms of POTS are widespread because the autonomic nervous system plays an extensive role in regulating functions throughout the body. The aim of this study is to determine the chronic pain symptoms in Postural Orthostatic tachycardia syndrome (POTS) patients. Method: Two hundred fifty-five (255) POTS patients were randomly selected from our clinic (January 2014 to March 2015) , reviewed the medical records of 255 POTS patients for chronic pain symptoms and performed data analysis. Results: Two hundred thirty-three of the 255 (91%) patients are females (n=233, age 29.20 ± 10.32), Twenty-three of the 255 (9%) patients are males (n=23, age 29.70 ± 14.52).63% (161 of the 255) had Joint Pain/aches, 51% (131 of the 255) had Chronic headache, 40% (102 of the 255) had chest pain, 31% (80 of the 255) had Migraine, 30% (76 of the 255) had Chronic back pain,16% (42 of the 255) had Heartburn,8%(20 of the 255) had Chronic pleurisy, Rheumatoid arthritis, Muscle aches, Chronic regional pain syndrome and Hip aches. Conclusion: Our study is the first to characterize that Patients with postural orthostatic tachycardia syndrome (POTS) have a very high prevalence of chronic pain symptoms.

scholarly journals The Use of Sub-Anesthetic Intravenous Ketamine and Adjuvant Dexmedetomidine when Treating Acute Pain from CRPS

2010 ◽  
Vol 4;13 (4;7) ◽  
pp. 365-368
Author(s):  
Daniel R. Meenan
Keyword(s):  
Nmda Receptor ◽  
Acute Pain ◽  
Intravenous Infusion ◽  
Symptom Relief ◽  
Pain Syndrome ◽  
Nmda Receptor Antagonist ◽  
Type I ◽  
Chronic Regional Pain Syndrome ◽  
Pain Symptoms

Complex regional pain syndrome (CRPS) is a pain condition of the extremities that presents with pain and allodynia, decreased range of motion, swelling and skin changes. There are 2 forms of CRPS — Type I which does not have demonstrable nerve lesions and Type 2, which has evidence of obvious nerve damage. Management of refractory CRPS has been challenging. Some studies have revealed that the Nmethyl-D-aspartic acid receptor (NMDAR) may be involved in the etiology of the pain in CRPS and perhaps that a NMDA receptor antagonist like Ketamine is a potential treatment for CRPS. However, the side effect profile of ketamine is concerning, and limiting the adverse effects of the drug is beneficial. Dexmedetomidine is an alpha 2 agonist similar to clonidine with analgesic properties that can be used in combination with ketamine to provide additional analgesia in CRPS. This case describes the treatment of acute pain symptoms from Chronic Regional Pain Syndrome-Type 1 (CRPS-1) with sub-anesthetic intravenous infusion of ketamine with adjunct dexmedetomidine. A 47-year-old female patient presented with severe pain, burning and allodynia from CRPS-1 refractory to conventional therapy. She was then admitted to a monitored bed, received a sub-anesthetic intravenous infusion of ketamine with adjunct dexmedetomidine for 19 hours and subsequently discharged with complete resolution of her pain and associated symptoms. Here, the synergistic effect of the ketamine and dexmedetomidine together is shown to provide excellent symptom relief while decreasing the total ketamine administered. The combination minimized unwanted side effects and eliminated the need for intensive care unit admission secondary to anesthetic doses of ketamine. Key words: CRPS; ketamine; dexmedetomidine; NMDA receptor; alpha 2 agonist; analgesia.

scholarly journals Percutaneous Tibial Nerve Stimulation in Chronic Post-Surgical Anorectal Pain: A Case Report

2021 ◽  
pp. 1-6
Author(s):  
Marta Pacheco ◽  
João Xavier ◽  
Olga Santos ◽  
Carina Raposo ◽  
Ana Margarida Regalado
Keyword(s):  
Nerve Stimulation ◽  
Negative Impact ◽  
Tibial Nerve ◽  
Pain Syndrome ◽  
Brief Pain Inventory ◽  
Lower Urinary Tract Dysfunction ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation ◽  
Anorectal Pain ◽  
Patient Reported

<b><i>Introduction:</i></b> Anorectal pain is a symptom with a negative impact on quality of life and it can sometimes develop into a chronic pain syndrome. Structural anorectal pain is treated according to the underlying pathology. In situations of chronic post-surgical pain that is refractory to conventional therapeutic approaches, percutaneous tibial nerve stimulation (PTNS) is an option. PTNS is a neurostimulation technique used in the treatment of lower urinary tract dysfunction. There has been increasing evidence of its benefits for improving other conditions, such as chronic pelvic pain (CPP) and faecal incontinence (FI). <b><i>Case Presentation:</i></b> We report a case of a 45-year-old woman with chronic post-surgical anorectal pain (CPAP) treated with PTNS. The patient reported a consistent and dramatic decrease in both the frequency and intensity of pain, assessed by the Brief Pain Inventory (BPI). A decrease in the pain interference with mood, normal work, and walking/mobility was also noted, as evaluated by BPI and EQ-5D-3L questionnaires. <b><i>Discussion:</i></b> Neuromodulation treatments have been reported as effective for anorectal pain, but reports on the use of PTNS are rare. The tibial nerve is easily accessible and provides an optimal site for neurostimulation without the need of an operating room or anaesthesia. The overall improvement observed in this case of chronic anorectal pain suggests a potential new area of research for PTNS.

scholarly journals A Long-Term Observation on the Possible Adverse Effects in Japanese Adolescent Girls after Human Papillomavirus Vaccination

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 856
Author(s):  
Akiyo Hineno ◽  
Shu-Ihi Ikeda
Keyword(s):  
Human Papillomavirus ◽  
Adverse Effects ◽  
Orthostatic Intolerance ◽  
Hpv Vaccination ◽  
Pain Syndrome ◽  
Causal Link ◽  
Human Papillomavirus Vaccination ◽  
Chronic Regional Pain Syndrome ◽  
Laboratory Test Results ◽  
Long Term Observation

In Japan, a significant number of adolescent females noted unusual symptoms after receiving the human papillomavirus (HPV) vaccination, of which the vast majority of them were initially diagnosed with psychiatric illnesses because of the absence of pathologic radiological images and specific abnormalities in laboratory test results. Later these symptoms were thought to be adverse effects of HPV vaccination. However, a causal link between HPV vaccination and the development of these symptoms has not been demonstrated. Between June 2013 and March 2021, we examined 200 patients who noted various symptoms after HPV vaccination. In total, 87 were diagnosed with HPV vaccination-related symptoms based on our proposed diagnostic criteria. The clinical histories of these 87 patients were analyzed. The age at initial vaccination ranged from 11 to 19 years old (mean ± SD: 13.5 ± 1.5 years old), and the age at the first appearance of symptoms ranged from 12 to 20 years old (mean ± SD: 14.3 ± 1.6 years old). The patients received an initial HPV vaccine injection between May 2010 and May 2013, but the first affected patient developed symptoms in October 2010, and the last affected developed symptoms in October 2015. A cluster of patients with a post-HPV vaccination disorder has not appeared in Japan during the last five years. Our study shows that, in Japan, the period of HPV vaccination considerably overlapped with that of a unique post-HPV vaccination disorder development. This disorder appears as a combination of orthostatic intolerance, chronic regional pain syndrome, and cognitive dysfunction, but its exact pathogenesis remains unclear.

scholarly journals The ENDOPAIN 4D Questionnaire: A New Validated Tool for Assessing Pain in Endometriosis

2021 ◽  
Vol 10 (15) ◽  
pp. 3216
Author(s):  
Anne Puchar ◽  
Pierre Panel ◽  
Anne Oppenheimer ◽  
Joseph Du Cheyron ◽  
Xavier Fritel ◽  
...  
Keyword(s):  
Minimal Clinically Important Difference ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
Dimensional Structure ◽  
Clinically Important Difference ◽  
Urinary Tract Symptoms ◽  
New Instrument ◽  
Patient Reported ◽  
Good Internal Consistency ◽  
Pain Symptoms

Objectives: To study the measurement properties, the responsiveness and the minimal clinically important difference of the ENDOPAIN-4D: a new questionnaire for assessing pain in endometriosis. Methods: A prospective, observational, multicentre study was conducted including all women ≥18 years consulting for symptomatic proven endometriosis between 1 January 2017 and 30 June 2018 and volunteering to participate. Each patient had to answer a new self-administered patient-reported outcome (PRO) questionnaires (the ENDOPAIN-4D) at inclusion (T0) and 12 months after medical or surgical treatment (T1). Criteria defined by COSMIN were used to validate the questionnaire's measurement properties. The minimal clinically important difference was estimated by the anchor-based method. Results: The study included 199 women. The ENDOPAIN-4D score had a four dimensional structure with good internal consistency (measured by Cronbach α): I) pain-related disability (α = 0.79), II) painful bowel symptoms (α = 0.80), III) dyspareunia (α = 0.83), and IV) painful urinary tract symptoms (α = 0.77). They produced four subscores that can be summed to obtain a single score (α = 0.61). The ENDOPAIN-4D total score ranged from 0 to 94.00 (mean ± SD: 46.7 ± 22). The total score was significantly correlated with the PROs used in endometriosis. Sensitivity to change was good with large effect sizes (ES) (mean of the differences: 36.3 p = 1.8 10−7, ES 0.76). The minimal clinically important difference of the global score was determined to be 10.9. Conclusions: The ENDOPAIN-4D questionnaire is easy to use, valid, and effective in assessing patient reported pain symptoms in women treated for endometriosis. This new instrument can be used as the primary outcome for future clinical trials and as a tool for routine patient follow-up.

scholarly journals Small Cell Carcinoma of the Uterine Cervix in a Pregnant Patient Diagnosed with Liquid Based Cytology and Cell Block Immunocytochemistry

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Mawuli F. Attipoe ◽  
Charles D. Sturgis
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Uterine Cervix ◽  
Case Reports ◽  
Pregnant Patient ◽  
Small Cell ◽  
Tumor Type ◽  
Cell Block ◽  
Current Case ◽  
Small Series

Definitive cytomorphologic diagnosis of small cell carcinoma of the uterine cervix is possible but can be challenging in routine cervicovaginal cancer screening specimens. Several small series of reported cases of cervical small cell carcinoma have shown this uncommon malignancy to represent fewer than 2% of all invasive cervical cancers. This tumor type is associated with poor prognosis and rapid disease progression and can develop to an advanced stage in the interval between screening visits. Only rare case reports of small cell carcinoma arising in gravid cervices are known. In the current case a 29-year-old, gravida 6, para 2, pregnant (10-week gestation) female presented with postcoital bleeding. A definitive diagnosis of small cell carcinoma of the cervix was made possible by liquid based Pap testing with ancillary cell block preparation allowing for immunocytochemical characterization of the lesional cell population.

scholarly journals Dysuria, Rebound Tenderness, and a Palpable Mass—A Ticking Time Bomb

2021 ◽  
Author(s):  
Tyler Miklovic ◽  
Philip Davis
Keyword(s):  
Emergency Department ◽  
Case Reports ◽  
Pubic Symphysis ◽  
Subsequent Treatment ◽  
Urachal Cyst ◽  
Significant Morbidity ◽  
Palpable Mass ◽  
Rebound Tenderness ◽  
Patient Reported ◽  
Middle Aged Adult

ABSTRACT A 37-year-old male presented to the emergency department with the complaint of periumbilical abdominal pain, radiating to just above pubic symphysis. The patient reported that the pain was worse with urination and associated with chills and nausea. This case reports discusses the Emergency Department (ED) course and subsequent treatment of a patient found to have an infected urachal cyst, a previously asymptomatic embryological anomaly in an otherwise healthy middle-aged adult male. This is a crucial diagnosis to make in order to avoid the potential for significant morbidity and/or mortality, given the unlikely symptomatic source.

scholarly journals Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

2020 ◽  
Vol 13 (2) ◽  
pp. e231995
Author(s):  
Brittany Sanford ◽  
Catherine Hoeppner ◽  
Tammy Ju ◽  
Brian K Theisen ◽  
Anna BuAbbud ◽  
...  
Keyword(s):  
General Surgery ◽  
Case Reports ◽  
Hepatocellular Adenoma ◽  
Multidisciplinary Care ◽  
Exploratory Laparotomy ◽  
Pregnant Patient ◽  
Haemorrhagic Shock ◽  
Liver Adenoma ◽  
Life Threatening ◽  
Temporary Closure

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

scholarly journals Transischiorectal fossa approach for resection of pudendal nerve schwannoma: case report

2016 ◽  
Vol 25 (5) ◽  
pp. 636-639 ◽  
Author(s):  
Stephanie Chen ◽  
Brandon Gaynor ◽  
Allan D. Levi
Keyword(s):  
Pelvic Pain ◽  
Pudendal Nerve ◽  
English Language ◽  
Case Reports ◽  
Laparoscopic Approach ◽  
Direct Access ◽  
Surgical Approaches ◽  
Complete Relief ◽  
Pelvic Muscles ◽  
Intraoperative Electrophysiological Monitoring

Pudendal nerve schwannomas are very rare, with only two cases reported in the English-language literature. The surgical approaches described in these two case reports are the transgluteal approach and the laparoscopic approach. The authors present the case of a patient with progressive pelvic pain radiating ipsilaterally into her groin, vagina, and rectum, who was subsequently found to have a pudendal schwannoma. The authors used a transischiorectal fossa approach and intraoperative electrophysiological monitoring and successfully excised the tumor. This approach has the advantage of direct access to Alcock's canal with minimal disruption of the pelvic muscles and ligaments. The patient experienced complete relief of her pelvic pain after the procedure.

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