The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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The Sphenopalatine Ganglion Radiofrequency Thermocoagulation on a Patient of CRPS with Facial Pain and Pruritus -A report of 2 cases-

얼굴 통증과 가려움증을 동반한 복합부위통증증후군 환자에서 나비입천장 신경절 고주파 열응고술 -증례보고-

  • Park, Seung Jae (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Moon, Dong Eon (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Won Young (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Jung Ju (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Cho, Eun Jeong (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Yang, Suk-Woo (Departments of Ophthalmology, College of Medicine, The Catholic University of Korea)
  • 박승재 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 문동언 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김원영 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 박정주 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 조은정 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 양석우 (가톨릭대학교 의과대학 안과학교실)
  • Received : 2006.10.11
  • Accepted : 2006.11.30
  • Published : 2006.12.30
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Abstract

Complex regional pain syndrome (CRPS) type 1 is characterized by the presence of pain, which is severe, diffuse and associated with allodynia, and is also associated with autonomic and trophic changes. The sensitization phenomena of CRPS also cause allodynia and itching, as well as pain. These symptoms are the issues associated with the treatment of CRPS. Under normal conditions, an antagonistic interaction exists between the pain and itching, but the patterns of peripheral and central sensitization phenomena for the pain and itching are very similar. The chronic pain and chronic itch have similar characteristics in their developmental and therapeutical principles. Herein, our experience of 2 cases of CRPS, which showed improvement of these facial symptoms after sphenopalatine ganglion radiofrequency thermocoagulation, but were not controlled by spinal cord stimulation or other conservative treatments, is reported.

Keywords

References

  1. MalekiJ, LeBel AA, Bennet GJ, Schwartzman RJ: Patterns of spread in complex regional pain syndrome, type I (reflex sympathetic dystrophy). Pain 2000; 88: 259-66 https://doi.org/10.1016/S0304-3959(00)00332-8
  2. Yang Y, Oraec S: A novel approach to transnasal sphenopalatine ganglion injection. Pain Physician 2006; 9: 131-4
  3. Stander S, Schmelz M: Chronic itch and pain-Similarities and differences. Eur J Pain 2006; 10: 473-8 https://doi.org/10.1016/j.ejpain.2006.03.005
  4. Wasner G, Schwarz K, Schattschneider J, Binder A, Jensen TS, Baron R: Interaction between histamine-induced itch and experimental muscle pain. Eur J Pain 2004; 8: 179-85 https://doi.org/10.1016/S1090-3801(03)00099-5
  5. Schmelz M: Itch and pain. Dermatol Ther 2005; 18: 304-7 https://doi.org/10.1111/j.1529-8019.2005.00039.x
  6. Day M: Neurolysis of the trigeminal and sphenopalatine ganglions. Pain Physician 2001; 1: 171-82
  7. Moses S: Pruritus. Am Fam Physician 2003; 68: 1135-42
  8. Stander S, Steinhoff M, Schmelz M, Weisshaar E, Metze D, Luget T: Neurophysiology of prurirus. Arch Dermatol 2003; 139: 1463-70 https://doi.org/10.1001/archderm.139.11.1463
  9. Szarvas S, Harmon D, Murphy D: Neuraxial opioid-induced pruritus: a review. J Clin Anesth 2003; 15: 234-9 https://doi.org/10.1016/S0952-8180(02)00501-9
  10. Oaklander AL, Bowshet D, Galer B, Haanpaa M, Jensen MP: Herpes zoster itch: preliminary epidemiologic data. J Pain 2003; 4: 338-43 https://doi.org/10.1016/S1526-5900(03)00637-0
  11. Edmonson BC, Wule AE: Ptosis evaluation and management. Otolaryngol Clin North Am 2005; 38: 921-46 https://doi.org/10.1016/j.otc.2005.08.012
  12. Shah RV, Racz GB: Long-term relief of posttraumatic headache by sphenopalatine ganglion pulsed radiofrequency lesioning: a case report. Arch Phys Med Rehabil 2004; 85: 1013-6 https://doi.org/10.1016/j.apmr.2003.07.017
  13. Sanders M, Zuurmond WW: Efficacy of sphenopalatine ganglion blockade in 66 patients suffering from cluster headache: a 12- to 70-month follow-up evaluation. J Neurosurg 1997; 87: 876-80 https://doi.org/10.3171/jns.1997.87.6.0876
  14. Day M, Racz G: Sphenopalatine ganglion blockade. In: Interventional pain management. 2nd ed. Edited by Waldman SD: Philadelphia, W.B. Saunders Company. 2001, pp 307-11
  15. Salar G, Ori C, lob I, Fiore D: Percutaneous thermocoagulation for sphenopalatine ganglion neuralgia. Acta Neurochir (Wien) 1987; 84:24-8 https://doi.org/10.1007/BF01456346
  16. Quevedo JP, Purgavie K, Platt H, Stax TE: Complex regional pain syndrome involving the lower extremity: a report of 2 cases of sphenopalatine block as a treatment option. Arch Phys Med Rehabil 2005; 86: 335-7 https://doi.org/10.1016/j.apmr.2004.04.033