Clinical observation of three-needle therapy combined with acupuncture on complex regional pain syndrome after stroke / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect of three-needle therapy combined with acupuncture on complex regional pain syndrome typeⅠ(CRPS-Ⅰ) after stroke.@*METHODS@#A total of 96 patients with CRPS-Ⅰ after stroke were randomized into an observation group and a control group, 48 cases in each one. In the control group, based on the routine treatment, acupuncture was applied at Neiguan (PC 6), Shuigou (GV 26), Sanyinjiao (SP 6) and other supplementary acupoints, once a day, 6 times a week for 3 weeks. Based on the treatment in the control group, three-needle therapy was added at coracoid process, greater tuberosity of humerus and infraglenoid tubercle, the muscular fascia was released by fan-shaped separation technique for 3-6 times, and the treatment was given once every 2 days, 3 times a week for 3 weeks. Visual analogue scale (VAS) score, hand swelling level, Fugl-Meyer assessment (FMA) score and Barthel index score were observed to evaluate the pain and swelling severity, motor function and living ability of patients before and after treatment.@*RESULTS@#① Compared before treatment, the VAS score, hand swelling level, the FMA score and the Barthel index after treatment and 40 days after treatment were improved in both of the two groups (0.05).@*CONCLUSION@# three-needle therapy combined with acupuncture can improve the pain severity and the motor function of affected limbs in patients with CRPS-Ⅰ after stroke, and the therapeutic effect may be sustained for a long term. However, the treatment seems to be ineffectual on extremity swelling.

Gustatory Change after Sympathetic Ganglion Block in Complex Regional Pain Syndrome Type I Patient: A case report

Some reports provide conclusive evidence of close interactive regulation between the taste receptor and sympathetic nervous system. We report a middle-aged male patient with gustatory change after cervical sympathetic ganglion block (CSGB) who had been suffering from hypersensitivity to sour taste since developing complex regional pain syndrome (CRPS) type 1, diagnosed according to the revised CRPS criteria. Despite receiving two high doses of prednisolone therapy, he experienced the recurrence of CRPS symptoms. We attempted other therapy treatments, including pamidronate intravenous infusion, non-steroidal anti-inflammatory drugs, opioids, tricyclic antidepressants, and CSGB. Following each CSGB administration, the patient reported decreased hypersensitivity to sour-tasting foods, such as kimchi and oranges, with decreased pain and reduction of dysautonomic symptoms. This case demonstrates that overactivation of the sympathetic nervous system may influence sensitivity and regulation of gustatory receptors; therefore, a patient demonstrating CRPS symptoms, including taste alterations, may respond positively to CSGB therapy.

Pathogenesis of Complex Regional Pain Syndrome (review) / 中国康复理论与实践

@# Complex regional pain syndrome (CRPS) is a neuropathic pain disorder, characterized with persistent and severe pain after trauma or surgery. This paper would review the epidemiology, mechanisms and pathophysiology of CRPS.

Infrared Thermal Imaging in Hemiplegic Patients of Upper Extremity by Stroke

OBJECTIVE: To investigate the usefulness of infrared thermal imaging for define the cause of shoulder pain on hemiplegic patients. METHOD: Subjects were 91 stroke patients who admitted to rehabilitation department from January 2002 to June 2003. Retrospective study was done by review of medical records. The subjects were divided into the control group (n=42) without shoulder pain and study group (n=49) who had the shoulder pain. The study group were also divided into subluxation, adhesive capsulitis, complex regional pain syndrome (CRPS) type I by main cause of pain. RESULTS: In the control group, the result revealed hypothermia on the involved upper extremity compared with the opposite intact side (p <0.05). In the study group, it revealed hyperthermia on the hand and forearm who diagnosed with CRPS type I. CONCLUSION: Distal infrared thermal imaging is considered to be useful diagnostic tool of CRPS type I in hemiplegic patient with shoulder pain.

The Effect of Intravenous Regional Block with Ropivacaine, Ketamine and Clonidine on Complex Reginal Pain Syndrome Type I: A case report / 대한마취과학회지

There is no treatment either to prevent the development of complex regional pain syndromes (CRPS), or to adequately and specifically control established pain. Symptom-based analysis of pain is important for disease progress assessments and treatment outcomes. An intravenous regional block (IVRB) with local anesthetics can contribute to the management of CRPS. We observed that by the IVRB using ropivacaine, ketamine and clonidine, the patient with CRPS type I who was resistant to sympathetic ganglion block and medical treatment with gabapentin, carbamazepine and antidepressant, was relieved of neuropathic pain.