Medina-Pérez Juan J, Vega-Rosas Andrés, Martínez-Espinosa Rubén A, Chávez-González Daniel, Coubert-Pelayo Silvia G
Pain Management Center, Hospital Ángeles Mocel, Mexico City, MEX.
Pain Clinic, Hospital Escandón, Mexico City, MEX.
Cureus. 2023 Sep 1;15(9):e44503. doi: 10.7759/cureus.44503. eCollection 2023 Sep.
Painful spastic hemiplegia is a common sequel to a stroke in which patients rarely achieve optimal levels of pain control. Herein, we report the case of a 62-year-old woman with painful spasticity secondary to an ischemic stroke of 15 years' evolution who received multiple pharmacological treatments without reaching motor or pain management goals. After an adequate analgesic response to the intrathecal baclofen test, the placement of an electromechanical pump was decided, reaching an effective maintenance dose of 150 μg per day. Despite achieving partial improvement in spasticity, optimal pain remission was achieved.
疼痛性痉挛性偏瘫是中风后的常见后遗症,患者很少能达到最佳的疼痛控制水平。在此,我们报告一例62岁女性患者,她因15年病程的缺血性中风继发疼痛性痉挛,接受了多种药物治疗,但未达到运动或疼痛管理目标。在鞘内注射巴氯芬试验获得充分的镇痛反应后,决定植入电动泵,维持剂量达到每天150μg有效。尽管痉挛得到部分改善,但疼痛得到了最佳缓解。