No abstract available.
Reflex Sympathetic Dystrophy* ; Reflex*

No abstract available.
Reflex Sympathetic Dystrophy*

No abstract available.
Angiography* ; Reflex Sympathetic Dystrophy* ; Reflex*

OBJECTIVE: The purposes of this study were to measure the effect of Stellate ganglion block(SGB) objectively and quantitatively by the use of sympathetic skin response(SSR), and to evaluate the cumulative effects and complications of repetitive SGB and to find out optimal numbers of injection per one cycle in the patients with reflex sympathetic dystrophy(RSD). METHOD: Six patients with RSD were evaluated with a SSR test before and after the injection of 1% lidocaine 4 ml by SGB method. RESULTS: There was a significant prolongation of latencies in SSR of the lesion side of sixty mixed cases by the SGB methods and SSR tests. There were no significant changes in the latency and amplitude of SSR from the lesion side between pre- and post injection states. There was a significant decrease of amplitude in the sound side after the injection. The differences of the amplitudes between pre- and post injections were significantly higher in the lesion side than the sound side. The degree of pain of the patients with RSD was evaluated by visual analogue scale(VAS), which scored on pre and post injection state decreased from 10 to 6.5 by 5 times injections, but did not decrease by more injections. CONCLUSION: We concluded that SGB is more effective in the RSD lesion side than the sound side and the SSR is a useful test for evaluating the effect of SGB.
Humans ; Lidocaine ; Reflex Sympathetic Dystrophy* ; Reflex* ; Skin* ; Stellate Ganglion*

OBJECTIVE: To determine the effects of the antiresorptive agent bisphosphonate in hemiplegic patients with CRPS and to compare its effects to standard steroid pulse therapy. METHOD: Thirteen randomly selected hemiplegic patients diagnosed with CRPS received bisphosphonate therapy which consisted of intravenous pamidronate injection of a total cumulative dose of 180 mg in one week. Eleven hemiplegic patients with CRPS received the standard 2-week steroid pulse therapy. Clinical assessments were made for temperature, pain score, volumetry and circumference of both the third digit and wrist. All assessments were carried out twice; before the initiation of therapy and two weeks after pamidronate or steroid therapy. RESULTS: The steroid group showed statistical improvement in pain (p=0.039), total hand volume(p=0.006) wrist (p= 0.007) and 3rd digit (p=0.003) circumference. The pamidronate group showed statistical improvement in pain (p=0.011), wrist (p=0.043) and 3rd digit (p=0.021) circumference; however no statistical improvement was observed in total hand volume (p=0.767). Neither group showed any statistical significance in temperature change. CONCLUSION: Pamidronate therapy may be an alternative method in managing CRPS in hemiplegic patients with multiple medical comorbidities who are not eligible to receive the conventional steroid therapy.
Comorbidity ; Diphosphonates ; Hand ; Hemiplegia ; Humans ; Reflex Sympathetic Dystrophy ; Steroids ; Wrist

The long-term prognosis of complex regional pain syndrome is difficult to predict because of its unclear pathophysiology. The syndrome can spontaneously spread to other regions in the body. We report a case in which a complex regional pain syndrome that occurred in a 75-year-old male patient after a stroke spread to the opposite side.
Aged ; Causalgia ; Humans ; Male ; Prognosis ; Reflex Sympathetic Dystrophy ; Stroke

Reflex sympathetic dystrophy is a common posttraumatic pain syndrome for which no relia- bly effective method of therapy has been found. Oral therapy has been attempted with steroid, tricyclic antidepressant, beta-blocker, and antiseizure medications, none of which are predictably helpful. Multiple invasive treatment, including sympathetic blockade and intravenous regional local anesthetic, reserpine, or guanethidine blocks, have been employed, but again with inconsistent success. Transcutaneous nerve stimulation is effective in some patients but aggravates symptoms in others. Following a report of the use of subarachnoid block in the treatment of reflex sympathetic dystrophy, a symptom that is characterized by vasospasm and cold intolerance, we experienced the ability of subarachnoid block to relieve the symptoms of reflex sympthetic dystrophy.
Guanethidine ; Humans ; Reflex Sympathetic Dystrophy* ; Reflex* ; Reserpine ; Transcutaneous Electric Nerve Stimulation

Pain in an extremity that develops following trauma, infection, thrombophlebitis and many other leaions has been recognized for years and designated by a variety of names. These syndromes appear to have the same physiopathology and response to therapy. All of them are characterized by exeessive unduly prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function and trophic changes. We have treated two cases of reflex sympathetic dystrophy. One case was only treated by stellate gangUon block repeated 26 times and the other case required surgical thoracic sympathectomy for complete recovery after 60 repeated stellate ganglion blocks. We report these two cases of reflex sympathetic dystrophy and review the literature.
Extremities ; Recovery of Function ; Reflex Sympathetic Dystrophy* ; Reflex* ; Stellate Ganglion ; Sympathectomy ; Thrombophlebitis

PURPOSE: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. MATERIALS AND METHODS: Patients with narrow range of age (21-25. mean 22.8+/-1.3, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed 21.2+/-7.3wks after trauma. RESULTS: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight bearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). CONCLUSION: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.
Cellulitis ; Foot ; Hand ; Humans ; Male* ; Reflex Sympathetic Dystrophy* ; Reflex* ; Sprains and Strains ; Tendons ; Weight-Bearing

Reflex sympathetic dystrophy syndrome is characterized by variable complex of the following symptoms, such as pain, tenderness, vasomotor instability, and trophic changes in distal extremities resulting from injury to either central or peripheral nervous tissue. We measured blood flow using radioisotope angiography with agent containing technecium-99m in one patient with reflex sympathetic dystrophy syndrome. Blood flow were significantly lower in affected side than normal side. After epidural block with 0.5% lidocaine and left lumbar sympathetic block with 100% alcohol, burning pain was disappeared and blood flow was increased to near or above in relation to the normal side. Radioisotope angiography is a noninvasive study and not so expensive. And we thought that radioisotope angiography may be a useful aid not only for diagnosis, but also for evaluating therapeu-tic response.
Burns ; Diagnosis ; Extremities ; Humans ; Lidocaine ; Radionuclide Angiography* ; Reflex Sympathetic Dystrophy* ; Reflex*