ABSTRACT
Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist.
Subject(s)
Adolescent , Adult , Child , Humans , Ankle , Causalgia , Complex Regional Pain Syndromes , Diagnosis , Electrodes , Ganglia, Sympathetic , Head , Lower Extremity , Neck , Nerve Block , Neuralgia , Pain Clinics , Psychiatry , Recurrence , Spinal Cord Stimulation , Spinal Cord , Splints , Stress, Psychological , Upper ExtremityABSTRACT
Complex regional pain syndrome (CRPS) type 1 is characterized by the presence of pain, which is severe, diffuse and associated with allodynia, and is also associated with autonomic and trophic changes. The sensitization phenomena of CRPS also cause allodynia and itching, as well as pain. These symptoms are the issues associated with the treatment of CRPS. Under normal conditions, an antagonistic interaction exists between the pain and itching, but the patterns of peripheral and central sensitization phenomena for the pain and itching are very similar. The chronic pain and chronic itch have similar characteristics in their developmental and therapeutical principles. Herein, our experience of 2 cases of CRPS, which showed improvement of these facial symptoms after sphenopalatine ganglion radiofrequency thermocoagulation, but were not controlled by spinal cord stimulation or other conservative treatments, is reported.
Subject(s)
Humans , Central Nervous System Sensitization , Chronic Pain , Electrocoagulation , Facial Pain , Ganglion Cysts , Hyperalgesia , Pruritus , Spinal Cord StimulationABSTRACT
Radiofrequency lesioning is a valuable tool for third occipital headache. Relative to most neural targets, a radiofrequency lesion is very small. Reliable pre-operative diagnosis of the nociceptive source is critical, as inappropriately placed lesions will not modulate pain. Knowledge of the anatomical courses of nerves and extremely precise electrode placement are required for accurate lesioning. This report describes our experience with RF lesioning in the treatment of chronic pain in two patients who suffered from third occipital headaches. In one patient, satisfactory improvement of the pain was observed after 10 months of follow up.
Subject(s)
Humans , Chronic Pain , Diagnosis , Electrodes , Follow-Up Studies , Headache , MouthABSTRACT
The purpose of this study was to evaluate the effects of toothpaste containing hydroxyapatite for patients who complained dental hypersensitivity. Before baseline of application of toothpaste with hydroxyapatite, tooth brushing instruction was done respectively and the several indices were measured at baseline, 2, 4, 8 weeks. Clinical indices were estimated, and responses to cold, compressive air, tactile stimulus were evaluated with verbal rating score. Relief effects and visual analogue scale were also evaluated. The results of this study were as follows 1. The occurrence rate of hypersensitivity in upper jaw was higher than that of lower jaws, and molar area showed more hypersensitivity than premolar and incisor area. Buccal site was hypersensitive followed by interproximal and lingual site. 2. Plaque index, gingival index and probing depth reduction were gradually improved after Tooth Brushing Instruction and using toothpaste. 3. Subjects showed most sensitive response to cold stimuli than compressive air and tactile stimuli. 4. The relief effect was increased during using tooth paste and complete relief was increased especially at 8 weeks. 5. Visual analogue scale was increased. In conclusion, it was confirmed that toothpaste containing microcrystalline hydroxyapatite have the relief effect of tooth hypersensitivity. During 8 weeks, stimulus responses were decreased and hypersensitivity relief effect was increased.
ABSTRACT
The purpose of this study was to evaluate the effects of toothpaste containing hydroxyapatite for patients who complained dental hypersensitivity. Before baseline of application of toothpaste with hydroxyapatite, tooth brushing instruction was done respectively and the several indices were measured at baseline, 2, 4, 8 weeks. Clinical indices were estimated, and responses to cold, compressive air, tactile stimulus were evaluated with verbal rating score. Relief effects and visual analogue scale were also evaluated. The results of this study were as follows 1. The occurrence rate of hypersensitivity in upper jaw was higher than that of lower jaws, and molar area showed more hypersensitivity than premolar and incisor area. Buccal site was hypersensitive followed by interproximal and lingual site. 2. Plaque index, gingival index and probing depth reduction were gradually improved after Tooth Brushing Instruction and using toothpaste. 3. Subjects showed most sensitive response to cold stimuli than compressive air and tactile stimuli. 4. The relief effect was increased during using tooth paste and complete relief was increased especially at 8 weeks. 5. Visual analogue scale was increased. In conclusion, it was confirmed that toothpaste containing microcrystalline hydroxyapatite have the relief effect of tooth hypersensitivity. During 8 weeks, stimulus responses were decreased and hypersensitivity relief effect was increased.
ABSTRACT
BACKGROUND: This study was performed to evaluate the effects of pretreatment with intralipos on the cardiovascular toxicity caused by continuous intravenous infusion with bupivacaine. METHODS: Fourteen healthy white rabbits were selected for this study and divided into the control group (n = 7) (normal saline administered for 30 minutes) and the intralipos pretreated group (n = 7) (intralipos administered for 30 minutes). The cardiovascular toxic effect during the continuous intravenous infusion of bupivacaine was observed between the control and the intralipos group by meaning the changes in mean arterial pressure, heart rate and electrocardiogram. RESULTS: In intralipos group, mean arterial pressure significantly increased after intralipos infusion for 30 minutes as compared with the control values (P < 0.05). The time intervals for 25, 50, 75 and 100% decrease in mean arterial pressure and heart rate and the onset time of the first QRS modification and dysrhythmia during continuous intravenous infusion of bupivacaine were significantly prolonged in the intralipos group compared with the control group (P < 0.05). The time intervals for 100% decrease in heart rate after the stop of bupivacaine administration was significantly prolonged in the intralipos group compared with the control group (P < 0.05). CONCLUSIONS: The present study suggests that prophylactic intravenous infusion with intralipos prevents the cardiovascular toxicity caused by bupivacaine in rabbits.