Therapeutic Effect of Pamidronate on the Post-Stroke ReflexSympathetic Dystrophy

ABSTRACT

OBJECTIVE: To evaluate the effects of pamidronate on post-stroke reflex sympathetic dystrophy (RSD). METHOD: Twenty four subacute stroke patients who fulfilled Kozin's criteria of RSD were enrolled in this study. Mixed with 500 ml of 5% glucose saline, 60 mg of pamidronate was intravenously administered daily for 3 consecutive days to make total dose of 180 mg. Clinical scores of the pain and swelling and the circumference of the middle finger were measured just before, 1 and 2 weeks after the injections. Three phase bone scintigraphy and bone densitometry (BMD) were performed before and 2 weeks after pamidronate injections. RESULTS: Clinical scores of the pain and swelling and the circumference of the middle finger improved significantly after pamidronate injections. The ratio of radioisotope uptake decreased in both blood pool and delayed phase images. BMD of ultradistal radius of the involved arm significantly increased after pamidronate injections. Eleven subjects developed fever or myalgia. Two subjects could not complete the injections due to severe allergic skin reaction. CONCLUSION: The intravenous pamidronate injection could be an effective therapeutic tool for post-stroke RSD.