Correlates and importance of neglect-like symptoms in complex regional pain syndrome

Neglect-like symptoms (NLS) are frequently observed in complex regional pain syndrome (CRPS). The clinical meaning of NLS, however, is largely unknown. Therefore, this study sets out to assess the importance of NLS for patient outcome and to explore their clinical correlates. We assessed NLS in a group of 53 patients with CRPS and compared the results to 28 healthy volunteers. To define the origin of the NLS reports, we tested the subjective visual midline, performed a limb-laterality recognition test, and quantitative sensory testing. In addition, psychological and pain assessment scales were completed. Tests were analyzed with univariate and multivariate approaches. After 6 months, patients were reassessed and the influence of NLS on pain outcome was determined. Most patients reported NLS in the questionnaire, whereas subjective visual midline and limb-laterality recognition test in contrast to previous studies did not reveal perceptual disturbances. Neglect-like symptom scores were associated with pain and pain catastrophizing in acute CRPS and anxiety and thermal sensory loss in chronic CRPS. Furthermore, high NLS scores had a negative impact on pain outcome after 6 months. Our results indicate that NLS have a different meaning in acute and chronic CRPS and might be of prognostic value. Possibly, treatment should focus on reducing NLS.
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

Related Links:

Hui Xu1,2,3, Chenguang Guo1, Haining Li1, Lin Gao2, Ming Zhang1* and Yuan Wang1* 1Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China 2Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China 3Faculty of Dentistry, University of Toronto, Toronto, ON, Canada Background and Purpose: Hemifacial spasm (HFS) is a rare neuromuscular disorder characterized by unilateral, involuntary, and paroxysmal contractions of orofacial muscles. To eluci...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Rationale: Ehlers–Danlos syndromes (EDSs) are a heterogeneous group of heritable connective tissue disorders involving defective collagen synthesis. Patients with EDS are prone for chronic myofascial pain, apart from other comorbidities. Although the initial pathology is commonly nociceptive, progression of EDS leads to neuropathies and central sensitization of pain signals. Overall, approximately 90% or more EDS patients suffer from chronic pain. There are no existing guidelines to manage chronic pain in EDS patients. In this article, we illustrate 2 case reports of EDS patients with chronic pain and review the re...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Chronic pain in adolescents is a serious issue that can lead to decreased social interactions, school absences, and impaired academic performance. In addition to physiologic, psychologic, and social factors, parental anxiety is believed to contribute to the development and maintenance of chronic pain. Retrospectively, we examined the charts of 144 patients, ages 8 –18, with various chronic pain conditions and placed them into one of six diagnostic groups: complex regional pain syndrome, abdominal pain, back pain, hypermobility, headache, and fibromyalgia.
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
Discussion: We found no added value of tDCS combined with GMI treatments for reducing pain in patients with chronic CRPS. However, given that GMI+sham tDCS induced no significant change, further studies comparing GMI+tDCS and tDCS alone are needed to further document tDCS’s effect in CRPS.
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
Publication date: Available online 14 October 2017 Source:Journal of Clinical Neuroscience Author(s): Koji Tamai, Zorica Buser, Christopher Wang, Permsak Paholpak, Hiroaki Nakamura, Jeffrey C. Wang, Patrick C. Hsieh Studies have demonstrated superior outcomes and cost effectiveness of the spinal cord stimulation (SCS) for the treatment of chronic pain syndromes such as failed back surgery syndrome (FBSS) or complex regional pain syndrome (CRPS). However, little is known about the impact of primary diagnosis or mental disorders on the revision rate. This is the Retrospective cohort study to analyze the reintervention rates...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
The pain seemed to come from nowhere. Although fifth-grader Amelia Watt had sprained her ankle playing soccer a few weeks earlier, the injury had seemed inconsequential. Yet now, she couldn’t put any weight on her foot without crying. Soon, the burning pain crept up her leg and her foot began to turn purple. Even taking a shower had become excruciating. At age 11, this vibrant, active girl was relegated to crutches, afraid to walk. Eventually, Amelia’s local physicians diagnosed her with complex regional pain syndrome (CRPS), a chronic pain condition believed to be caused by malfunction of the nervous system. C...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: Diseases & Conditions Our Patients’ Stories chronic pain Chronic Pain Clinic complex regional pain syndrome Dr. Edin Randall Pediatric Pain Rehabilitation Center (PPRC) Source Type: news
Conclusions: Currently available immersive virtual reality technology with myolectric and motion tracking control may represent a possible therapy option for treatment-resistant phantom limb pain. Keywords: virtual reality, phantom limb pain, rehabilitation, amputation, therapy, pain Innov Clin Neurosci. 2017;14(7–8):3–7 Phantom limb pain (PLP), the sensation of pain in an absent limb, is a frequent complication after amputation, with reported prevalence rates ranging from 40 to 85 percent.1,2 While the exact mechanism of PLP remains to be elucidated, peripheral and central neural factors are thought to contrib...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue amputation pain phantom limb pain rehabilitation therapy virtual reality Source Type: research
The objectives of our study were to define and validate 4 bedside tests, to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions, and to assess the clinical utility (sensitivity, specificity, positive predictive value, negative predictive value) for identifying CRPS within a Fracture cohort. This was a single UK teaching hospital prospective cohort study with 313 recruits from pain-free volunteers and patients with chronic pain conditions. Four novel tests were Finger Perception (FP), Hand Laterality identification (HL), Astereognosis (AS), and Body Scheme (BS) report. Five que...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
Conclusions The study provides new insights into adolescents’ own experiences of complex persistent pain occurring unexpectedly, developing dramatically over time, and influencing all parts of their everyday lives. The adolescents entered vicious cycles, with despair and decreased physical and social functioning, with the risk of isolation and role-loss. However, these young people seem to have a strong motivation to strive for normalcy. Implications These findings may encourage healthcare providers to perceive adolescents’ persistent pain through the lenses of a biopsychosocial approach. We suggest that furthe...
Source: Scandinavian Journal of Pain - Category: Anesthesiology Source Type: research
“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.” The opioid crisis has been fueled by the use of opioids to treat chronic pain.  Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids.  I’ve sat through community ‘heroin forums’ (sometimes on stage) as sheriffs, politicians, and ‘recovered addicts’ firmly pointed fingers at health professionals.  I, meanwhile, kept my finger under the table, but had the t...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Buprenorphine Chronic pain Suboxone treatment buprenorphine treats chronic pain chronic pain treatment opioid induced hyperalgesia opioid pain relief pain vs. addiction Source Type: blogs
More News: Anxiety | Chronic Pain | Complex Regional Pain Syndrome | Pain | Psychology | Study