|From Lost and Tired|
Of course, the banner at the top of the PubMed page reads:
PubMed is open, however it is being maintained with minimal staffing due to the lapse in government funding. Information will be updated to the extent possible, and the agency will attempt to respond to urgent operational inquiries.Part of the reason I've not yet posted Part Two of the latest Clinical Trials updates for CRPS is precisely because they are shut down, though the staff there is also operating on a "compassionate" basis, helping people with end stage cancers find trials to try. There are angels everywhere. Yes, yes, I am sure there are even some GOP members who sport halos.
Anyway, I'm posting the abstract for this case study about immunoglobulin infusions in treating CRPS because some wider (and much older) research studies have claimed success in reducing pain -- significantly -- with as high a success rate as 30-40%. The usual caveat seems to hold true -- that the likelihood of IVIG being effective is greatest in that magic initial 3 to 6 month period after onset. So many people face huge battles in getting a correct diagnosis, often for years, so hearing that "3-6 month" mantra again is a bit of a downer. But as groups like RSDSA.org continue the battle for awareness and research, maybe these promising treatments will start reaching that target demographic and there will be fewer and fewer "intractable" cases of CRPS.
I took my optimism pill this morning. That said, please do remember that this is a case study. But heck, it was a case study that caught someone's attention about ketamine. And from ketamine has been extrapolated experimental uses of other drugs blocking NMDA receptors -- she said, hopefully, taking her Namenda (memantine)!
Clin J Pain.2013 Nov;29(11):e33-e34.
Favorable Outcome of an Acute Complex Regional Pain Syndrome With Immunoglobulin Infusions.
Medlin F, Zekeridou A, Renaud S, Kuntzer T.
Nerve-Muscle Unit, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
To emphasize that complex regional pain syndrome (CRPS), a disabling disorder with the implication of aberrant inflammation, vasomotor dysfunction, and maladaptive neuroplasticity, might be treated with a high dose of intravenous immunoglobulin infusions (IVIG).
We describe a patient who presented with CRPS in the acute phase of the disease.
The CRPS developed secondary to sciatic compression in a young patient and was treated within 10 days by high-dose IVIG (2 g/kg). It resolved completely within days after infusions.
This observational study emphasizes that high-dose IVIG may be a treatment option in the acute phase of CRPS.
Please excuse the funky layout below. Blogger is punking me.
Intravenous immunoglobulin treatment of the complex regional pain syndrome: a randomized trial.
PRIMARY FUNDING SOURCE:
- Intravenous immunoglobulin to fight complex regional pain syndromes: hopes and doubts. [Ann Intern Med. 2010]
Summary for patients in
But what would a post be without a measure of balancing skepticism? Here is a taste of some of the immediate reaction to this 2010 study in the form of an editorial, even -- you'll have to use your "zoom" function to enlarge it, sorry!
© 2013 L. Ryan