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CRPS stroke

François Luthi, Pierre-Alain Buchard, Antonio Cardenas, Christine Favre, Michel Fédou, Marlène Folif, Jean Savoy, Jean-Luc Turlan, Michel Konzelmann
The Complex Regional Pain Syndrome (previously algodystrophy) is a rare affliction that usually affects a distal extremity (hand, foot). It occurs most frequently within weeks following a traumatic injury or stroke. It is a syndromic entity whose diagnosis is based on precise criteria, known as the Budapest criteria, excluding any disease that better explains the symptoms. The treatment must be given early. Functional restoration (physiotherapy, occupational therapy) is at the heart of the treatment, along with psychoeducation...
February 27, 2019: Revue Médicale Suisse
Samaa Al Sayegh, Tove Filén, Mats Johansson, Susanne Sandström, Gisela Stiewe, Stephen Butler
Background and purpose This case of a 42 year old woman with lower extremity Complex Regional Pain Syndrome (CRPS) after a twisting injury of the ankle, effectively treated with the addition of mirror therapy to a rehabilitation programme, prompted a literature review of both CRPS and mirror therapy. Mirror therapy is a newer adjunct to other forms of pain control and functional restoration for treatment of CRPS as well as other difficult clinical problems. This was a required group project as part of a university based course in chronic pain for healthcare workers...
October 1, 2013: Scandinavian Journal of Pain
Lin Xie, Mengjun Li, Shijie Dang, Chaomin Li, Xiaoni Wang, Binbin Liu, Mengqi Mei, Jianbao Zhang
OBJECTIVES: Although recent animal studies have highlighted the importance of cardiorespiratory coupling in the pathogenesis of hypertension, little research has assessed the cardiorespiratory coupling in humans at high risk of developing hypertension. The aim of this study was to investigate the cardiorespiratory coupling in healthy young individuals genetically predisposed to hypertension at both rest and mental stress conditions. METHODS: We studied 39 normotensive male participants [21 with (FH+) and 18 without (FH-) a family history of hypertension]...
November 2018: Journal of Hypertension
Ahry Lee, Youjin Jung, Hee-Kyu Kwon, Sung-Bom Pyun
Complex regional pain syndrome (CRPS) type I in stroke patients is usually known to affect the hemiplegic upper limb. We report a case of CRPS presented in an ipsilesional arm of a 72-year-old female patient after an ischemic stroke at the left middle cerebral artery territory. Clinical signs such as painful range of motion and hyperalgesia of her left upper extremity, swollen left hand, and dystonic posture were suggestive of CRPS. A three-phase bone scintigraphy showed increased uptake in all phases in the ipsilesional arm...
February 2018: Annals of Rehabilitation Medicine
Brandon A Howard, Lance Roy, Alan David Kaye, Srinivas Pyati
PURPOSE OF REVIEW: To describe the current understanding of the role of three-phase bone scintigraphy (TPBS) in the diagnosis and management of complex regional pain syndrome (CRPS), discuss its advantages and limitations, and present three examples of TPBS patterns typically seen in CRPS patients. RECENT FINDINGS: CRPS is a debilitating disorder frequently presenting with pain to ordinarily non-painful stimuli, redness, swelling, following fractures, stroke, myocardial infarction, surgery, or even minor trauma, and its diagnosis, based on clinical criteria and supportive imaging findings, is difficult...
February 1, 2018: Current Pain and Headache Reports
Sung Ho Jang, Chul Hoon Chang, Young Jin Jung, You Sung Seo
RATIONALE: We report on a stroke patient who showed restoration of discontinued corticoreticular pathways (CRPs) on serial diffusion tensor tractography (DTT) concurrent with recovery of gait disturbance following shunt operation for hydrocephalus. PATIENT CONCERNS: A 67-year-old female patient underwent stereotactic drainage for management of intraventricular hemorrhage due to a rupture of the left posterior communicating artery. DIAGNOSES: After 4 weeks from onset, the patient exhibited quadriparesis with more severe weakness in the proximal muscles and could not even stand or walk...
January 2018: Medicine (Baltimore)
Jayantee Kalita, Usha Misra, Ajit Kumar, Sanjeev K Bhoi
BACKGROUND: There is no study on the long-term use of prednisolone in post-stroke complex regional pain syndrome-1 (CRPS1). OBJECTIVE: To evaluate the efficacy and safety of long-term low dose prednisolone in post-stroke CRPS-I. STUDY DESIGN: Open-labeled randomized controlled trial. SETTING: Tertiary care teaching institute. METHODS: Seventy-seven out of 396 (19.4%) patients with stroke had CRPS-1 and 58 met the inclusion criteria...
November 2016: Pain Physician
Jong Ho Choi, Ki Pi Yu, Yong-Soon Yoon, Eun Sil Kim, Ji Hyun Jeon
OBJECTIVE: To investigate the relationship between glycosylated hemoglobin A (HbA1c) and complex regional pain syndrome (CRPS) in stroke patients with type 2 diabetes mellitus (T2DM). METHODS: A retrospective chart review was performed of stroke patients from January 2012 to December 2013. We reviewed 331 patients and included 200 in the analysis. We divided them into CRPS and non-CRPS groups and compared them by age, gender, stroke lesion, cause of stroke, duration of T2DM, HbA1c (%), National Institutes of Health Stroke Scale score, affected shoulder flexor muscle strength, Fugl-Meyer Assessment score, motricity index, Functional Independence Measure, Korean version of Modified Barthel Index, blood glucose level on admission day, duration from stroke onset to HbA1c check, and duration from stroke onset to three-phase bone scan for CRPS diagnosis...
October 2016: Annals of Rehabilitation Medicine
Yong Wook Kim, Yoon Kim, Jong Moon Kim, Ji Seong Hong, Hyun Sun Lim, Hyoung Seop Kim
Patients with poststroke complex regional pain syndrome (CRPS) show different symptoms compared to other types of CRPS, as they usually complain of shoulder and wrist pain with the elbow relatively spared. It is thus also known by the term "shoulder-hand syndrome."The aim of this study is to present a possible pathophysiology of poststroke CRPS through ultrasonographic observation of the affected wrist before and after steroid injection at the extensor digitorum communis (EDC) tendon in patients suspected with poststroke CRPS...
August 2016: Medicine (Baltimore)
Andrew K Treister, Maya N Hatch, Steven C Cramer, Eric Y Chang
Pain after stroke is commonly reported but often incompletely managed, which prevents optimal recovery. This situation occurs in part because of the esoteric nature of poststroke pain and its limited presence in current discussions of stroke management. The major specific afflictions that affect patients with stroke who experience pain include central poststroke pain, complex regional pain syndrome, and pain associated with spasticity and shoulder subluxation. Each disorder carries its own intricacies that require specific approaches to treatment and understanding...
January 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Keith M Smart, Benedict M Wand, Neil E O'Connell
BACKGROUND: Complex regional pain syndrome (CRPS) is a painful and disabling condition that usually manifests in response to trauma or surgery. When it occurs, it is associated with significant pain and disability. It is thought to arise and persist as a consequence of a maladaptive pro-inflammatory response and disturbances in sympathetically-mediated vasomotor control, together with maladaptive peripheral and central neuronal plasticity. CRPS can be classified into two types: type I (CRPS I) in which a specific nerve lesion has not been identified, and type II (CRPS II) where there is an identifiable nerve lesion...
February 24, 2016: Cochrane Database of Systematic Reviews
H Eun Young, K Hyeyun, I Sang Hee
OBJECTIVES: This study aims to compare the effectiveness of a bisphosphonate (pamidronate) and a steroid (prednisolone) in complex regional pain syndrome (CRPS) type I during four weeks of follow-up in hemiplegic stroke patients. METHODS: Twenty-one hemiplegic stroke patients with CRPS type I were enrolled in the study. Patients were randomly assigned to receive either intravenous pamidronate (n = 11; total cumulative dose of 180 mg) or oral prednisolone (n = 10)...
January 2016: Netherlands Journal of Medicine
Engin Koyuncu, Güldal Funda Nakipoğlu Yüzer, Didem Yenigün, Neşe Özgirgin
CASE: A patient who developed hemiplegia related to a hemorrhagic stroke and who had not been started on venous thromboembolism prophylaxis or a physical medicine and rehabilitation program was admitted to our clinic on the 4th month after the event. Our patient had pain, swelling, redness, increased temperature at the right lower extremity, range of motion limitation at the hip and knee, deep vein thrombosis (DVT) and complex regional pain syndrome (CRPS) at the same side lower extremity, and heterotopic ossification (HO) at the hip...
March 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Marianne David, Hubert R Dinse, Tina Mainka, Martin Tegenthoff, Christoph Maier
Achieving perceptual gains in healthy individuals or facilitating rehabilitation in patients is generally considered to require intense training to engage neuronal plasticity mechanisms. Recent work, however, suggested that beneficial outcome similar to training can be effectively acquired by a complementary approach in which the learning occurs in response to mere exposure to repetitive sensory stimulation (rSS). For example, high-frequency repetitive sensory stimulation (HF-rSS) enhances tactile performance and induces cortical reorganization in healthy subjects and patients after stroke...
2015: Frontiers in Neurology
Asli Topcuoglu, Nilufer Kutay Ordu Gokkaya, Halil Ucan, Dilek Karakuş
BACKGROUND AND PURPOSE: Complex regional pain syndrome type I (CPRS I), is a complex of symptoms characterized by diffuse pain usually with associated swelling, vasomotor instability, and severe functional impairment of the affected extremity in stroke patients. Pain is a prominent feature and is often refractory to variety of treatment. METHODS: To investigate the clinical, functional, and psychosocial effects of upper extremity aerobic exercise (UEAE) and compare the effect of aerobic exercise with that of conventional physiotherapy in patients with CPRS type I following stroke as a randomized controlled assesor blinded 4  week-study...
August 2015: Topics in Stroke Rehabilitation
Faustine L Dufka, Troels Munch, Robert H Dworkin, Michael C Rowbotham
Evidence-based medicine rests on the assumption that treatment recommendations are robust, free from bias, and include results of all randomized clinical trials. The Repository of Registered Analgesic Clinical Trials search and analysis methodology was applied to create databases of complex regional pain syndrome (CRPS) and central post-stroke pain (CPSP) trials and adapted to create the Repository of Registered Analgesic Device Studies databases for trials of spinal cord stimulation (SCS), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS)...
January 2015: Pain
V K Parmar, L Gee, H Smith, J G Pilitsis
Refractory pain syndromes often have far reaching effects and are quite a challenge for primary care providers and specialists alike to treat. With the help of site-specific neuromodulation and appropriate patient selection these difficult to treat pain syndromes may be managed. In this article, we focus on supraspinal stimulation (SSS) for treatment of intractable pain and discuss off-label uses of deep brain stimulation (DBS) and motor cortex stimulation (MCS) in context to emerging indications in neuromodulation...
August 2014: Clinical Neurology and Neurosurgery
Kao-Chih Hsu, Shin-Tsu Chang
We present a right-hemispheric stroke patient with complex regional pain syndrome (CRPS). Symptoms of CRPS developed in conjunction with a corresponding elevation of the contralateral thalamic flow when the glycosylated hemoglobin values were high (16.1% and 13.4%), twice observed as migration from the bottom to the top location of the thalamus. CRPS improved after the glycosylated hemoglobin level reduced to 10.6% and 8.3%. Poor blood sugar control might cause redistribution of thalamic regional blood flow and be associated with the persistence of CRPS in this case...
November 27, 2013: Journal of Diabetes Investigation
Susan Marzolini, Ada Tang, William McIlroy, Paul I Oh, Dina Brooks
BACKGROUND: Individuals referred to cardiac rehabilitation programs (CRPs) after stroke have demonstrated postprogram improvements in cardiovascular fitness (VO2peak). However, the effect of CRPs on other physiological/quality-of-life outcomes and effect of time from stroke on these results has not been investigated. The objectives of the present study are (1) to evaluate the effects of a CRP in participants with motor impairment after stroke and (2) to explore the effects of elapsed time from stroke on physiological/quality-of-life outcomes...
July 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Eun Young Han, Han Young Jung, Myeong Ok Kim
PURPOSE: The objective was to determine whether the abnormal finding of somatosensory evoked potentials (SEPs) associated with the development of type I complex regional pain syndrome (CRPS) after stroke. METHODS: This was a retrospective study conducted from January, 2003, to December, 2007. Seventy patients were confirmed as CRPS type I, and one hundred and eighty-two patients were assigned to the control group. The initial clinical data were reviewed including age, gender, main type of stroke, lateralization and location of the lesion, presence of glenohumeral subluxation, and the development of CRPS...
2014: Disability and Rehabilitation
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