1/5. Management of post-traumatic pain syndromes (causalgia).A number of post-traumatic pain syndromes may be grouped under the two headings: causalgia and mimocausalgia states. Our concern is the early recognition of patients whose complaints have a real organic basis but whose physical signs are not of sufficient degree to make this fact readily apparent. These patients are all too often mismanaged or neglected for sufficiently long periods of time to permit the underlying pathologic physiology to secure supremacy over normal function. Recognized and treated properly by means of sympathetic ablation, either medical or surgical, the vast majority can be relieved of their symptoms. The extremities can then be rehabilitated by appropriate measures.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
2/5. Thoracoscopic sympathectomy in causalgia.causalgia, the post-traumatic pain syndrome remains one of the most poorly understood and frequently misdiagnosed entities encountered in clinical practice. Ablation of the upper thoracic sympathetic trunk has been used for over a century with variable success for a variety of conditions. Endoscopic transthoracic techniques of ablation of the sympathetic trunk have the advantage of a minimally invasive approach with excellent visualization of the sympathetic trunk and rapid postoperative recovery. We discuss a case of causalgia in a 35 years old man with 15 years duration of symptoms (stage 2 Drucker) in whom nonoperative therapy has consisted of drug therapy (phenytion, amitriptyline, carbamazepine, beclofen, ibuprofen and diclofenac Na), intermittent sympathetic blocks and physiotherapy failed, but full degree of pain relief was achieved by thoracic T2-T3 sympathectomy endoscopically without any major complication. Endoscopic transthoracic techniques for sympathectomy are a major technical advance in the management of causalgia and pancreatic pain. The operation is safe, effective and well tolerated and leads to a high level of patient satisfaction. Further applications of this technique are inevitable and are likely to replace conventional open procedures.- - - - - - - - - - ranking = 0.2keywords = post-traumatic (Clic here for more details about this article) |
3/5. causalgia: clarifications in terminology and a case presentation.By way of literature review, clarifications are made in the terminology employed in discussing the atypical post-traumatic pain syndromes, particularly reflex sympathetic dystrophy (RSD). causalgia is a form of RSD and is the focus of a case report presented from the files at St. Anne's Hospital-West, Northlake, illinois.- - - - - - - - - - ranking = 0.2keywords = post-traumatic (Clic here for more details about this article) |
4/5. The diagnosis and management of post-traumatic pain syndromes (causalgia).There are two major categories of post-traumatic pain syndroms: (1) causalgia; and (2) mimocausalgia states or reflex sympathetic dystrophy. vasoconstriction is usually present. Because of the pain, limitation of motion of the extremity occurs, and may result in permanent disability. There is often a great disparity between the apparent trauma and the severity of the pain. Sympathetic blocks and sympathectomy are definitive modes of therapy. In a series of 147 patients, 56% required surgical sympathectomy. The rest were treated by sympathetic blocks, physical therapy, and other medical measures. Eighty-two percent had excellent relief of pain, 11% had good relief, while 7% had no relief. Thirty-one percent of patients had residual symptoms resulting from the original injury, or from irreversible occurrences on the basis of pain and trophic changes. Emphasis is placed on early recognition and proper treatment.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
5/5. Post-traumatic pain syndromes.A number of post-traumatic pain syndromes may be grouped as causalgia or mimocausalgia. These are important entities and should be well known to most disciples of medicine. Our concern is the early recognition of patients whose complaints have an organic basis but whose physical signs are not of sufficient degree to make this fact readily apparent. These patients are often misunderstood and discredited. They are all too often mismanaged or neglected for so long that the underlying pathologic physiology secures supremacy over normal function. Recognized and treated properly by means of sympathetic ablation, either medical or surgical, the vast majority of symptoms can be relieved. The extremities then can be rehabilitated by appropriate measures.- - - - - - - - - - ranking = 0.2keywords = post-traumatic (Clic here for more details about this article) |