Santamato Andrea, Ranieri Maurizio, Panza Francesco, Solfrizzi Vincenzo, Frisardi Vincenza, Stolfa Ida, Megna Marisa, Fiore Pietro
Department of Physical Medicine and Rehabilitation, University of Foggia, Foggia, Italy.
Pain Med. 2009 Jan;10(1):179-85. doi: 10.1111/j.1526-4637.2008.00539.x.
Complex regional pain syndrome (CRPS) is a clinical entity that has been termed in numerous ways in the last years. Clinically, CRPS describes an array of painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. The pain is regional and usually has a distal predominance of abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings.
Case report.
University Medical Center. Patients. In this report, we described the case of a 68-year-old hemiplegic female affected by cerebrovascular accident that presented a clinical case of CRPS shoulder-hand syndrome (CRPS-SHS) at the right hand after a hemorrhagic stroke.
This report evaluated the effects of biphosphonates and lymphatic drainage type Leduc in CRPS-SHS.
The pain level of the patients was measured with the visual analog scale. A scoring system for the clinical severity of CRPS-SHS, laboratory tests, and X-ray films were also performed.
We reported in this patient a great improvement of pain and edema of the right hand, with a significant reduction of bone demineralization.
This combined treatment may be a viable alternative for this syndrome; however, further investigation is needed to determine its reproducibility in large case series.
复杂区域疼痛综合征(CRPS)是一种近年来有多种命名的临床病症。临床上,CRPS描述了一系列疼痛状况,其特征为持续性(自发和/或诱发)的局部疼痛,在时间或程度上似乎与任何已知创伤或其他损伤的通常病程不相称。疼痛是局部性的,通常在远端出现异常的感觉、运动、汗腺分泌、血管舒缩和/或营养方面的表现。
病例报告。
大学医学中心。患者。在本报告中,我们描述了一名68岁的偏瘫女性病例,该患者因脑血管意外导致出血性中风后,右手出现了CRPS肩手综合征(CRPS-SHS)的临床病例。
本报告评估了双膦酸盐和勒迪克氏淋巴引流法对CRPS-SHS的影响。
采用视觉模拟量表测量患者的疼痛程度。还进行了CRPS-SHS临床严重程度的评分系统、实验室检查和X线片检查。
我们报告该患者右手的疼痛和水肿有显著改善,骨矿物质流失明显减少。
这种联合治疗可能是该综合征的一种可行替代方案;然而,需要进一步研究以确定其在大型病例系列中的可重复性。