scholarly journals Acute worsening of clinical presentation in CRPS after SARS-CoV-2 (COVID-19) vaccination: a case series

2021 ◽  
Author(s):  
Jessica Zhang ◽  
Semih Gungor
Keyword(s):  
General Population ◽  
Complex Regional Pain Syndrome ◽  
Medical Management ◽  
Clinical Presentation ◽  
Case Series ◽  
Pain Syndrome ◽  
Individualized Therapy ◽  
Type I ◽  
Mortality And Morbidity ◽  
Clinical Worsening

We present the acute worsening of clinical presentation in complex regional pain syndrome (CRPS), following mRNA-based COVID-19 vaccination. We report the case series of three patients diagnosed with CRPS type I who presented with acute worsening of symptoms after mRNA-based COVID-19 vaccination and their medical management. The acute clinical worsening after mRNA-based COVID-19 vaccination was transient and effectively managed with adjustment of individualized therapy in all three patients. The mortality and morbidity of COVID-19 infection are serious, and vaccination is recommended in the general population, including patients with a diagnosis of CRPS. However, clinicians should be aware of the possibility that there may be a clinical worsening CRPS after mRNA-based COVID-19 vaccination.

scholarly journals Pulsed Radiofrequency Treatment of Complex Regional Pain Syndrome: A Case Series

2014 ◽  
Vol 19 (4) ◽  
pp. 186-190 ◽  
Author(s):  
Vlad Djuric
Keyword(s):  
Pain Relief ◽  
Lower Extremity ◽  
Effective Treatment ◽  
Complex Regional Pain Syndrome ◽  
Present Report ◽  
Case Series ◽  
Pain Syndrome ◽  
Sympathetic Chain ◽  
Type I ◽  
Pulsed Radiofrequency

BACKGROUND: Various forms of sympathetic chain neurolysis (sympathectomy) have, at one time or another, held promise as effective treatment options for complex regional pain syndrome (CRPS). Complications, such as worsening pain and the development of new pain syndromes, have prevented sympathectomy from emerging as a standard intervention. In an effort to avoid poor outcomes associated with neurolysis, pulsed radiofrequency (PRF) has been proposed as a potential treatment alternative for a number of chronic neuropathic pain states, including some forms of CRPS.METHODS: The present report describes three cases in which patients diagnosed with lower extremity CRPS type I obtained substantial and lasting intervals of pain relief following PRF of the lumbar sympathetic chain. Over a period of four years, 14 fluoroscopically guided procedures using PRF lesioning of the lumbar sympathetic chain at L2, L3 and L4 were performed in three individuals with CRPS type I of the lower limb. Outcome measures included pre- and post-treatment self-reported pain and medication requirements.RESULTS: Substantial pain relief (>50%) was achieved in 91.7% of PRF applications at three months and 83.3% at six months, with some treatments resulting in persistent relief well beyond 12 months. Medication use decreased to a comparable degree, with discontinuation of opiates after all but three treatments.CONCLUSIONS: PRF lesioning of the lumbar sympathetic chain can be an effective treatment for patients with CRPS type I of the lower extremity, with the potential to provide ≥6 months of substantial pain relief.

scholarly journals The Prevalence of Autoantibodies in Complex Regional Pain Syndrome Type I

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Maaike Dirckx ◽  
Marco W. J. Schreurs ◽  
Marissa de Mos ◽  
Dirk L. Stronks ◽  
Frank J. P. M. Huygen
Keyword(s):  
General Population ◽  
Complex Regional Pain Syndrome ◽  
Antinuclear Antibodies ◽  
Pain Syndrome ◽  
Systemic Autoimmune Disease ◽  
Healthy Population ◽  
Type I ◽  
Antineuronal Antibodies ◽  
Pathophysiologic Mechanisms

Autoimmunity has been suggested as one of the pathophysiologic mechanisms that may underlie complex regional pain syndrome (CRPS). Screening for antinuclear antibodies (ANA) is one of the diagnostic tests, which is usually performed if a person is suspected to have a systemic autoimmune disease. Antineuronal antibodies are autoantibodies directed against antigens in the central and/or peripheral nervous system. The aim of this study was to compare the prevalence of these antibodies in CRPS patients with the normal values of those antibodies in the healthy population. Twenty seven (33%) of the 82 CRPS patients of whom serum was available showed a positive ANA test. This prevalence is significantly higher than in the general population. Six patients (7.3%) showed a positive result for typical antineuronal antibodies. This proportion, however, does not deviate from that in the general population. Our findings suggest that autoantibodies may be associated with the pathophysiology of CRPS, at least in a subset of patients. Further research is needed into defining this subset and into the role of autoantibodies in the pathogenesis of CRPS.

Peripheral Nerve and Brachial Plexus Impairment, AMA Guides, Sixth Edition

2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Complex Regional Pain Syndrome ◽  
Lower Extremities ◽  
Pain Syndrome ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Type I ◽  
Sixth Edition ◽  
Nerve Entrapments

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.

Stimulation of Dorsal Root Ganglia for the Management of Complex Regional Pain Syndrome: A Prospective Case Series

Pain Practice ◽  
2014 ◽  
Vol 15 (3) ◽  
pp. 208-216 ◽  
Author(s):  
Jean-Pierre Van Buyten ◽  
Iris Smet ◽  
Liong Liem ◽  
Marc Russo ◽  
Frank Huygen
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Dorsal Root Ganglia ◽  
Dorsal Root ◽  
Case Series ◽  
Pain Syndrome ◽  
Prospective Case Series ◽  
Stimulation Of

Effect of spinal cord stimulation in Type I complex regional pain syndrome with 2 rare severe cutaneous manifestations

2009 ◽  
Vol 110 (2) ◽  
pp. 274-278
Author(s):  
Kim Rijkers ◽  
Jasper van Aalst ◽  
Erkan Kurt ◽  
Marc A. Daemen ◽  
Emile A. M. Beuls ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Complex Regional Pain Syndrome ◽  
Female Patient ◽  
Spinal Cord Stimulation ◽  
Scientific Literature ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type ◽  
Cutaneous Manifestations ◽  
Giant Bullae

The authors present the case of a 49-year-old female patient with complex regional pain syndrome–Type I (CRPSI) who was suffering from nonhealing wounds and giant bullae, which dramatically improved after spinal cord stimulation (SCS). The scientific literature concerning severe cutaneous manifestations of CRPS-I and their treatment is reviewed. Nonhealing wounds and bullae are rare manifestations of CRPS-I that are extremely difficult to treat. Immediate improvement of both wounds and bullae after SCS, such as in this case, has not been reported previously in literature. Considering the rapidly progressive nature of these severe skin manifestations, immediate treatment, possibly with SCS, is mandatory.

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