Ranker Alexander, Behr-Eggers Elke
Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Praxis für Allgemeinmedizin, Amelinghausen, Deutschland.
Schmerz. 2023 Dec;37(6):468-472. doi: 10.1007/s00482-022-00682-6. Epub 2022 Dec 2.
The case of a 51-year-old patient with complex regional pain syndrome (CRPS) of the left hand after radius distortion is reported. Anticonvulsant therapy was difficult in this case due to persisting epilepsy with already dual therapy (lamotrigine and brivaracetam) at high dosage. With existing neuropathic pain, pronounced allodynia and hyperhidrosis, repetitive transcutaneous monophasic electrotherapy was applied above the stellate ganglion. A ganglion blockage could not be clinically confirmed in the absence of Horner syndrome, but neuropathic pain and hyperhidrosis could be positively influenced. This case report summarizes the electrode positions used, current parameters, pitfalls and therapy limitations and discusses them in relation to the literature.
报告了一例51岁患者,其在桡骨变形后出现左手复杂性区域疼痛综合征(CRPS)。由于患者持续患有癫痫,且已采用高剂量的两种药物联合治疗(拉莫三嗪和布瓦西坦),因此抗惊厥治疗困难。鉴于患者存在神经性疼痛、明显的痛觉过敏和多汗症,在星状神经节上方进行了重复经皮单相电疗法。由于没有霍纳综合征,无法通过临床确认神经节阻滞,但神经性疼痛和多汗症得到了积极改善。本病例报告总结了所使用的电极位置、电流参数、陷阱和治疗局限性,并结合文献进行了讨论。