Wednesday, July 24, 2013

An Unusual Case Study of CRPS Movement Disorder: Drexel Cheerleaders!

Drexel Cheerleaders

As my struggle with CRPS evolves -- we are in our eleventh year together -- more and more, the pain that I cannot tolerate is born from dystonia / spasticity / Jerk-O-Rama sessions.  Much time and mental energy is wasted as CRPS endeavors to turn my feet and legs into some sort of fancy artisinal pretzel.  The solution is an intrathecal delivery device for a sufficient amount of baclofen to render my muscles, nerves, and connective tissues all loosey-goosey and amenable to the instructions delivered by the central nervous system.  Because of my body's decision to harbor bacteria in my bones (osteomyelitis) in the form of evil biofilm communities, I cannot have any further "implants," as they'll only become another petri dish for bacterial growth.  


I joke, but it is hell.  

RSDSA has an excellent little library subsection on CRPS movement disorders/dystonia.  Check it out!

The latest paper I've come across comes from some of the best -- the CRPS Brethren of Drexel's Department of Neurology:

Complex regional pain syndrome with associated chest wall dystonia: a case report.

David J. Irwin and Robert J. Schwartzman
Drexel University College of Medicine, Department of Neurology, Philadelphia, PA, USA

David J Irwin MD
Robert J Schwartzman MD
Department of Neurology
Drexel University College of Medicine
New College Building
245 N 15tl1 St
Philadelphia P A USA 19102
TEL: (215) 762-7090; FAX: (215) 762-3161;
e-mail: (corresponding author),

Patients with complex regional pain syndrome (CRPS) often suffer from an array of associated movement disorders, including dystonia of an affected limb. We present a case of a patient with long standing CRPS after a brachial plexus injury, who after displaying several features of the movement disorder previously, developed painful dystonia of chest wall musculature. Detailed neurologic examination found palpable sustained contractions of the pectoral and intercostal muscles in addition to surface allodynia. Needle electromyography of the intercostal and paraspinal muscles supported the diagnosis of dystonia. In addition, pulmonary function testing showed both restrictive and obstructive features in the absence of a clear cardiopulmonary etiology. Treatment was initiated with intrathecal baclofen and the patient had symptomatic relief and improvement of dystonia. This case illustrates a novel form of the movement disorder associated with CRPS with response to intrathecal baclofen treatment.

Keywords: complex regional pain syndrome, dystonia, movement disorder, dyspnea

© 2013 L. Ryan

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