Complex Regional Pain Syndrome of Non-hemiplegic Upper Limb in a Stroke Patient: A Case Report
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Complex regional pain syndrome (CRPS) type I in stroke patients is usually known to affect the hemiplegic upper limb. We report a case of CRPS presented in an ipsilesional arm of a 72-year-old female patient after an ischemic stroke at the left middle cerebral artery territory. Clinical signs such as painful range of motion and hyperalgesia of her left upper extremity, swollen left hand, and dystonic posture were suggestive of CRPS. A three-phase bone scintigraphy showed increased uptake in all phases in the ipsilesional arm. Diffusion tensor tractography showed significantly decreased fiber numbers of the corticospinal tract and the spinothalamic tract in both unaffected and affected hemispheres. Pain and range of motion of the left arm of the patient improved after oral steroids with a starting dose of 50 mg/day.
Abstract
Complex regional pain syndrome (CRPS) type I in stroke patients is usually known to affect the hemiplegic upper limb. We report a case of CRPS presented in an ipsilesional arm of a 72-year-old female patient after an ischemic stroke at the left middle cerebral artery territory. Clinical signs such as painful range of motion and hyperalgesia of her left upper extremity, swollen left hand, and dystonic posture were suggestive of CRPS. A three-phase bone scintigraphy showed increased uptake in all phases in the ipsilesional arm. Diffusion tensor tractography showed significantly decreased fiber numbers of the corticospinal tract and the spinothalamic tract in both unaffected and affected hemispheres. Pain and range of motion of the left arm of the patient improved after oral steroids with a starting dose of 50 mg/day.
참고문헌 (10)
- Norman Harden R, "CRPS: current diagnosis and therapy", pp.45~58 (2005), IASP Press
- Marinus J, "Clinical features and pathophysiology of complex regional pain syndrome", Lancet Neurol, 10, pp.637~648 (2011)[DOI]
- Chae J, "Poststroke complex regional pain syndrome", Top Stroke Rehabil, 17, pp.151~162 (2010)[DOI]
- Schwenkreis P, "Functional imaging of central nervous system involvement in complex regional pain syndrome", AJNR Am J Neuroradiol, 30, pp.1279~1284 (2009)[DOI]
- Geha PY, "The brain in chronic CRPS pain: abnormal gray-white matter interactions in emotional and autonomic regions", Neuron, 60, pp.570~581 (2008)[DOI]
- Azqueta-Gavaldon M, "Basal ganglia dysfunction in complex regional pain syndrome: a valid hypothesis?", Eur J Pain, 21, pp.415~424 (2017)[DOI]
- Han EY, "Absent median somatosensory evoked potential is a predictor of type I complex regional pain syndrome after stroke", Disabil Rehabil, 36, pp.1080~1084 (2014)[DOI]
- Hong JH, "Neural tract injuries by brain herniations after head trauma", J Head Trauma Rehabil, 27, pp.154~158 (2012)[DOI]
- Hong JH, "Injury of the spino-thalamo-cortical pathway is necessary for central post-stroke pain", Eur Neurol, 64, pp.163~168 (2010)[DOI]
- Wasner G, "Complex regional pain syndrome: diagnostic, mechanisms, CNS involvement and therapy", Spinal Cord, 41, pp.61~75 (2003)[DOI]
