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Thursday, November 8, 2012
CRPS and Shingles: Two Articles in PAIN
Development of CRPS after shingles: It’s all about location - October 10, 2012(Pain) Although the goal of medicine is to cure disease, effective treatment of the symptoms that the patient notices requires that the clinician identify their underlying cause – namely the diagnosis. Without a diagnosis, clinicians can only palliate the symptoms and hope that the actual disease resolves on its own. The 20th century brought great advances in understanding disease pathophysiology. For instance, we learned that seemingly identical coughs can have causes as diverse as infection, cancer, heart failure, or asthma, each requiring different diagnostic and therapeutic responses....
Albrecht PJ, Hines S, Eisenberg E, Pud D, Finlay DR, Connolly MK, et al. Pathologic alterations of cutaneous innervation and vasculature in affected limbs from patients with complex regional pain syndrome. PAIN®. 2006;120:244–266
Kohr D, Tschernatsch M, Schmitz K, Singh P, Kaps M, Schafer KH, et al. Autoantibodies in complex regional pain syndrome bind to a differentiation-dependent neuronal surface autoantigen. PAIN®. 2009;143:246–251
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A rare case of complex regional pain syndrome II follows acute varicella zoster virus infection in the arm.
Complex regional pain syndrome (CRPS) and postherpetic neuralgia (PHN) represent neuropathic pain syndromes that may appear with similar clinical signs and symptoms. Medical history and clinical distribution of symptoms and signs (PHN typically at the thorax; CRPS typically at the limbs) is obvious in most cases, helping to discriminate between both disorders. Here, we present a patient suffering from CRPS II following PHN of one upper extremity. This case demonstrates that both etiology and part of the body affected by a neuropathy influence the pain phenotype.
Eyigor S, Durmaz B, Karapolat H. Monoparesis with complex regional pain syndrome-like symptoms due to brachial plexopathy caused by the varicella zoster virus: a case report. Arch Phys Med Rehabil. 2006;87:1653–1655
Maier C, Baron R, Tolle TR, Binder A, Birbaumer N, Birklein F, et al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): somatosensory abnormalities in 1236 patients with different neuropathic pain syndromes. PAIN®. 2010;150:439–450
Watson CP, Oaklander AL, Deck H. The neuropathology of herpes zoster with particular reference to postherpetic neuralgia and its pathogenesis. In: Watson CP, Gershon AA editor. Herpes zoster and postherpetic neuralgia. 2nd revised and enlarged ed.. Cambridge, UK: Elsevier; 2001;p. 167–182
Weiss S, Streifler M, Weiser HJ. Motor lesions in herpes zoster. Incidence and special features. Eur Neurol. 1975;13:332–338
Wuppenhorst N, Maier C, Frettloh J, Pennekamp W, Nicolas V. Sensitivity and specificity of 3-phase bone scintigraphy in the diagnosis of complex regional pain syndrome of the upper extremity. Clin J Pain. 2010;26:182–189