Spinal Cord Stimulation as Treatment for Complex Regional Pain Syndrome Should Be Considered Earlier Than Last Resort Therapy

Poree, Lawrence; Krames, Elliot S.; Pope, Jason E.; Deer, Timothy R.; Levy, Robert M.; Schultz, Louise

doi:10.1111/ner.12035

Cited by 88 publications

(52 citation statements)

References 138 publications

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“…This complication may not be readily attributed to the operative positioning amongst some nonsurgical specialties. Timely diagnosis of chronic neuropathic pain, referral and treatment could result in earlier institution of neuromodulation particularly in complex regional pain syndrome [5]. The early frustrations with patient selection criteria and equipment difficulties have diminished secondary to carefully controlled studies and improvements in equipment designs.…”

Section: Discussionmentioning

confidence: 99%

Challenges of Peripheral Nerve Stimulator Implantation in a Patient with New Onset Thrombocytopenia

Thompson¹

2015

J Neurol Neurosci

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Section: Discussionmentioning

confidence: 99%

Challenges of Peripheral Nerve Stimulator Implantation in a Patient with New Onset Thrombocytopenia

Thompson¹

2015

J Neurol Neurosci

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“…The practitioner must be vigilant about managing tolerance, and the risks of opioid-induced hyperalgesia or overdose. 29,30 A case series of 5 patients demonstrated that combined SCS and intrathecal baclofen neuromodulation decreased pain autoantibodies to target structures, enhancing central sensitization. 3 • NMDA antagonist, ketamine infusion.…”

Section: Topics In Pain Management February 2015mentioning

confidence: 99%

Topics in Pain Management CME Quiz

2015

Topics in Pain Management

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“…In einer Kohortenstudie an 84 Patienten über einen Zeitraum von 12 Jahren zeigte sich diese Methode in 63 % der Fälle eff ektiv in der Langzeitbehandlung, wobei eine Schmerzlinderung von mindestens 50 % auf der visuellen Analogskala innerhalb einer Woche nach der Implantation mit einem Langzeiterfolg assoziiert war [ 64 ] . Eine Übersichtsarbeit empfi ehlt die SCS frühzeitiger in der Behandlung des CRPS einzusetzen [ 65 ] . Jedoch war in 61 % der behandelten Patienten im Verlauf mindestens eine Reintervention notwendig [ 64 ] .…”

Section: Spinal-cord-stimulation (Scs)unclassified

Neues aus der Forschung zum Komplexen Regionalen Schmerzsyndrom (CRPS)

2013

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▼ Complex regional pain syndrome (CRPS) typically develops following extremity injuries and is characterised by distally generalised sensory, motor, trophic, vaso-and sudomotor dysfunctions, as well as joint affl iction. CRPS cases without nerve lesions are defi ned as type I -those involving nerve damage as type II. The diagnosis is primarily based on the clinical presentation using the so called 'Budapest criteria'. Important for the diagnosis is the exclusion of other potential conditions which could account for the patient-reported symptoms and demonstrable clinical signs. Triple-phase bone scans are helpful for the early and diff erential diagnosis due to their high specifi city (98 %), although their sensitivity decreases as the disease progresses. In the acute stage of the disease, pro-infl ammatory factors seem to play an important role, allowing for a potential therapeutic approach. As the disease progresses, however, they are unrelated to the clinical severity. Chronic stages are primarily determined by central nervous system changes including a reduced cortical representation of the aff ected limb, changes in body scheme, neglectlike symptoms, as well as dystonic deformities. The most common sensory abnormality is pressure hyperalgesia over muscles, most likely a result of peripheral sensitisation. In addition to the clinically detectable focal autonomic disorders, more generalised autonomic dysfunction is also found. The pathogenesis of dystonic symptoms, however, remains poorly understood, making therapeutic treatment more diffi cult. Treatment of CRPS should be multimodal and take place in a multi-disciplinary setting, adapted to the level of pain. Invasive interventions should be limited to strict indications and specialised centres.

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Spinal Cord Stimulation as Treatment for Complex Regional Pain Syndrome Should Be Considered Earlier Than Last Resort Therapy

Cited by 88 publications

References 138 publications

Challenges of Peripheral Nerve Stimulator Implantation in a Patient with New Onset Thrombocytopenia

Challenges of Peripheral Nerve Stimulator Implantation in a Patient with New Onset Thrombocytopenia

Topics in Pain Management CME Quiz

Neues aus der Forschung zum Komplexen Regionalen Schmerzsyndrom (CRPS)

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