• Annals of Clinical Neurophysiology
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• v.9 no.1
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• pp.36-38
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• 2007

The pathomechanisms involved in both restless legs syndrome (RLS) and complex regional pain syndrome type I (CRPS I) are still controversial whether they are central or peripheral origins. We recently encountered a patient who had an unusual coexistence of both RLS and CRPS I, and both of which showed good responses to sympathetic block. These findings suggest the role of peripheral mechanisms, especially unmyelinated small autonomic fiber, in both RLS and CRPS I.

• Annals of Clinical Neurophysiology
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• v.24 no.2
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• pp.35-45
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• 2022

Complex regional pain syndrome (CRPS) is a chronic regional pain disorder that most frequently affects the limbs. It is characterized by hyperalgesia, allodynia, edema, motor disturbance, and vasomotor instability, and typically occurs following surgery or trauma. In type-I CRPS there is no confirmed nerve injury, while peripheral nerve injury is present in type-II CRPS. The multifactorial pathophysiological etiology of CRPS includes inflammation, autoimmune responses, abnormal cytokine production, autonomic dysfunction, altered blood flow, psychological factors, and central cortical reorganization. There are no specific laboratory diagnostic tools for CRPS, and so it is diagnosed clinically. The Budapest criteria are currently the most-accepted diagnostic criteria.

• Journal of Acupuncture Research
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• v.33 no.3
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• pp.181-187
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• 2016

Objectives : The purpose of this study is to report the clinical effects of 8 constitution acupuncture on a patient with complex regional pain syndrome (CRPS) type I. Methods : In this study, a patient with CRPS was treated by 8 constitution acupuncture therapy. He was diagnosed in the Cholecystonia of 8 constitution diagnosis. The progress of symptoms were evaluated by visual analog scale (VAS) and sleeping time. VAS and sleeping time were evaluated at 7:00 am daily. Results : VAS decreased from 10 to 4, while sleeping time increased from 30 minutes to 3 hours. Conclusion : The results suggest that 8 constitution acupuncture is effective for treating symptoms of CRPS type I.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.157-185
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• 2009

Objectives : The aim of this study is to suggest approach of oriental medical management and necessity by research of eastern and western medical literatures for Complex Regional Pain Syndrome(CRPS). Methods : We reviewed the clinical and experimental literatures of eastern and western concerned with CRPS which is related causation, signs and symptoms, diagnosis, etiology and management. Results : 1. CRPS is divided into type I and II by nerve injury. Two types of CRPS have been recognized: type I, corresponds to RSD and occurs without a definable nerve lesion, and type II, formerly called causalgia refers to cases where a definable nerve lesion is present. These conditions can be charaterized clinically by the sensory abnormalities, vascular abnormalities, oedema, sweating abnormalities, motor or trophic changes. 2. CRPS are well known to patients and physicians relatively, but the pathophysiology, causation and treatments are still unclear. 3. CRPS is needed to take the early diagnosis and multidisciplinary approach for significant effect. 4. CRPS can be regarded for obstruction syndrome of Ki and blood(痺證), blood stasis(瘀血), Wei symptom(痿證), numbness(痲木) in the oriental medical management of CRPS. Conclusions : Above the results, it is suggested that further studies and active approach of management of CRPS will be conducted precisely in oriental medicine.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.60-65
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• 2007

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

• Journal of Korean Medicine Rehabilitation
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• v.21 no.3
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• pp.79-87
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• 2011

Objectives : The aim of this study was to observe the pain relief effect of moxibustion therapy in a patient with complex regional pain syndrome(CRPS). Methods : A male with type I CRPS, 48-year-old, who suffered from severe pain and paresthesia on his legs despite of treatments of oral medications and spinal cord stimulation was treated by indirect moxibustion following Korean medicine dianosis. Total 20 moxibustion treatments(once daily, 5 days a week, for 4 weeks) were given on the 4 acupoints(both side) where known to be effective fro the CRPS. Visual analogue scale(VAS), digital infrared thermal imaging(DITI), Beck depression index(BDI) were evaluated before and after the treatments. Pain relief, thermal changes on affected legs, and improvement of depression scale were observed after the treatments. Results : As for DITI, right thigh showed low temperature compared with left on before the treatments. While after the treatments, DITI showed similar temperature in both legs at discharge day. Conclusions : Though it is a case report, moxibustion therapy might have pain relief effect. Further rigorous case series and controlled trials are warranted.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.251-254
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• 2000

A 20-year-old male patient developed severe right leg pain, hyperesthesia and allodynia after multiple lumbar epidural blocks. His pain was neuropathic pain (complex regional pain syndrome type I). The patient was treated with repeated administration of epidural ketamine at the rate of 0.2~0.7 mg/kg on multiple occasions. Complete relief of pain was achieved.

• Journal of Haehwa Medicine
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• v.18 no.1
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• pp.109-116
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• 2009

Objective: The objective of this study is to observe the effect of anti-inflammatory herbal acupuncture on the Complex Regional Pain Syndrome Methods : Anti-inflammatory herbal acupuncture, A-Shi Point, Sa-am acupunture were used to treat shoulder pain & ROM(range of movement)disorder, chest pain, finger's causalgic pain. We evaluated the patient through VAS(Visual Analog Scale) daily and Physical Examinations Results & Conclusions : After 42days of treatment, shoulder pain was decreased from VAS10 to VAS3, chest pain was decreased from VAS10 to VAS1.5, finger's causalgic pain was decreased from VAS10 to VAS2.5. and the patient showed that the ROM(range of movement) of shoulder was better, oriental treatment is good method for pain relief and better movement.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.190-194
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• 2007

Complex regional pain syndrome (CRPS), which is a syndrome that is defined by pain and sudomotor and/or vasomotor instability, is usually resistant to conventional treatment. Here, a case involving a 30-year-old male patient with CRPS type I who showed severe intractable right shoulder pain with allodynia and hyperalgesia despite being treated with oral medications, nerve blocks including thoracic sympathetic neurolysis, and spinal cord stimulation is described. The patient frequently visited the emergency room due to severe uncontrollable breakthrough pain. Although a favorable effect was observed in response to intermittent ketamine infusion therapies that were performed on an outpatient basis, acute exacerbation of pain occurred frequently during the night and could not be controlled. Therefore, subcutaneous ketamine infusion therapy using a patient-controlled analgesic system was attempted and found to effectively control acute exacerbation of pain during 6 weeks of infusion without serious complications.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.223-227
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• 2006

Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.