A Case of Intractable Chest Pain of Unknown Origin which was Suspicious of Complex Regional Pain Syndrome Type I -A case report-

복합부위통증증후군 제1형으로 추정되는 상세불명의 흉부격통 치료 경험 -증례보고-

Jin, Soon-Yong;Han, Young-Jin;Choe, Huhn
진순용;한영진;최훈

  • Published : 20041100

Abstract

Complex regional pain syndrome (CRPS) type I is an intractable pain syndrome accompanied with autonomic nerve symptoms, but without certain evidence of nerve injury. It is mainly caused by trauma, such as, fracture, sprain, contusion, etc., and is characterized by, pain (either by contact or spontaneously), allodynia, hyperalgia, vasomotor, and autonomic changes (including variable skin color changes), temperature change, swelling, edema, sweating, trophic change, and motor disturbance. We report the case of a 60-year-old woman who had suffered from severe pain on the right chest for several years. She was satisfactorily treated by pharmacologic therapy and continuous epidural nerve block.

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References

  1. Turner-Strokes L: Reflex sympathetic dystrophy - a complex regional pain syndrome. Disabil Rehabi Med 2002; 24: 939-47 https://doi.org/10.1080/0963828021000007950
  2. Geurts AC, Visschers BA, van Limbeek J, Ribbers GM: Systemic review of aetiology and treatment of post-stroke hand edema and shoulder-hand syndrome. Scand J Rehab Med 2000; 32: 4-10 https://doi.org/10.1080/003655000750045668
  3. Poncelet C, Perdu M, Levy-WeilF, Philippe HJ, Nisand I: Reflex sympathetic dystrophy in pregnancy: nine cases and a review of the literature. Eur J Obstet Gynecol Reprod Biol 1999; 86: 55-63 https://doi.org/10.1016/S0301-2115(99)00051-2
  4. Baron R, Levine JD, Fields HL: Causalgia and reflex sympathetic dystrophy: does the sympathetic nerve system contribute to the generation of the pain? Muscle Nerve 1999; 22: 346-52
  5. Drummond PD, Finch PM, Symthe GA: Reflex sympathetic dystrophy: the significance of differing plasma catecholamine concentrations in affected and unaffected limbs. Brain 1991; 114: 2025-36 https://doi.org/10.1093/brain/114.5.2025
  6. Goldstein DS, Tack C, Li ST: Sympathetic innervation and function in reflex sympat-hetic dystrophy. Ann Neurol 2000; 48: 49-59 https://doi.org/10.1002/1531-8249(200007)48:1<49::AID-ANA8>3.0.CO;2-T
  7. Wasner G, Schatschneider J, Binder A, Baron R: Complex regional pain syndome - diagnostic, mechanisms, CNS involvement and therapy. Spinal Cord 2003; 41: 61-75 https://doi.org/10.1038/sj.sc.3101404
  8. Blumberg H, Janig W: Clinical manifestations of reflex sympathetic dystrophy and sympathetically maintained pain. In: Textbook of pain. 3rd ed. Edited by Wall PD, Melzack R: Edinburgh, Churchill Livingstone. 1994, pp 685-98
  9. Veldman PHJM, Reynen HM, Amtz IE, Goris RJA: Signs and symptoms of reflex sympathetic dystrophy: prospctive study of 829 patients. Lancet 1993; 342: 1012-6 https://doi.org/10.1016/0140-6736(93)92877-V
  10. Sandroni P, Low PA, Ferrer T, Opfer-Gehrking TL, Willner CL, Wilson PR: Complex regional pain syndrome I (CRPS I): prospective study and laboratory evaluation. Ciln J Pain 1998; 14: 282-9 https://doi.org/10.1097/00002508-199812000-00003
  11. Kozin F, Ryan LM, Carerra GE, Soin JS, Wortmann RL: The reflex sympathetic dystrophy syndrome (RSDS). Am J Med 1981; 70: 23-30 https://doi.org/10.1016/0002-9343(81)90407-1
  12. Gibbons J, Wilson PR: RSD score: criteria for the diagnosis of reflex sympathetic dystrophy and causalgia. Clin J Pain 1992; 8: 260-3 https://doi.org/10.1097/00002508-199209000-00012
  13. Max MB: Treatment of post-herpetic neuralgia: antidepressants. Ann Neurol 1994; 35: S50-3
  14. Max MB, Lynch SA, Muir J, Shoaf SE, Smoller B, Dubner R: Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. N Engl J Med 1992; 326: 1250-6 https://doi.org/10.1056/NEJM199205073261904
  15. Mellick GA, Mellicy LB, Mellick LB: Gabapentin in the management of the reflex sympathetic dystrophy. J Pain Symptom Manage 1995; 10: 265-6 https://doi.org/10.1016/0885-3924(95)00001-F
  16. Christensen K, Jensen EM, Noer I: The reflex dystrophy syndrome response to treatment with systemic corticosteroids. Acta Chir Scand 1982; 148: 653-5
  17. Zyluk A: Results of the treatment of posttraumatic reflex sympathetic dystrophy of the upper extremity with regional intravenous blocks of methylprednisolone and lidocaine. Acta Orthop Belg 1998; 64: 452-6
  18. Jung SM, Han KR, Ock KJ, Park SK, Kim C, Kim JS, et al: Effect of repeated lumbar sympathetic ganglion block with triamcinolone on complex regional pain syndrome of vascular origin. J Korean Pain Soc 2001; 14: 118-22