Journal of Yeungnam Medical Science

Communication

Algorithm for multimodal medication therapy in patients with complex regional pain syndrome: Min Cheol Chang, Donghwi Park; J Yeungnam Med Sci. 2023;40(Suppl):S125-S128. Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00360

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Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a clinical entity characterized by classic neuropathic pain, autonomic involvement, motor symptoms, and trophic changes in the skin, nails, and hair. Although various therapeutic modalities are used to control CRPS-related pain, severe pain due to CRPS often persists and progresses to the chronic phase. In this study, we constructed an algorithm for multimodal medication therapy for CRPS based on the established pathology of CRPS. Oral steroid pulse therapy is recommended for initial pain management in patients with CRPS. Oral steroid therapy can reduce peripheral and central neuroinflammation, contributing to the development of neuropathic pain during the acute and chronic phases. If steroid pulse therapy offers poor relief or is ineffective, treatment to control central sensitization in the chronic phase should be initiated. If pain persists despite all drug adjustments, ketamine with midazolam 2 mg before and after ketamine injection can be administered intravenously to inhibit the N-methyl D-aspartate receptor. If this treatment fails to achieve sufficient efficacy, intravenous lidocaine can be administered for 2 weeks. We hope that our proposed drug treatment algorithm to control CRPS pain will help clinicians appropriately treat patients with CRPS. Further clinical studies assessing patients with CRPS are warranted to establish this treatment algorithm in clinical practice.

Citations

Citations to this article as recorded by

Problems of diagnosis and treatment of chronic pain syndrome in patients with variants of the structure of peripheral nerves. A series of clinical cases
Al'bert R. Bulatov, Tatyana A. Kolesnik, Александра A. Boykova, Igor' V. Litvinenko, Nikolay V. Tsygan
Russian Military Medical Academy Reports.2023; 42(4): 413. CrossRef
Experience from a single-center study on multimodal medication therapy for patients with complex regional pain syndrome
Donghwi Park, Jin-Woo Choi, Min Cheol Chang
Journal of Back and Musculoskeletal Rehabilitation.2023; : 1. CrossRef

Case report

Septo-optic dysplasia associated with chromosome 15q13.3 duplication: a case report: Jeong A Ham, Sung Hyun Kim, Donghwi Park; J Yeungnam Med Sci. 2023;40(4):419-422. Published online December 2, 2022; DOI: https://doi.org/10.12701/jyms.2022.00493

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Abstract PDF: Septo-optic dysplasia (SOD) is a rare congenital anomaly that is clinically defined by developmental delay and characteristic brain magnetic resonance imaging findings, including optic nerve hypoplasia, pituitary hormone abnormalities, and midline brain defects. The occurrence of SOD is generally sporadic; however, it can be inherited rarely. Although an association with HESX1, SOX2, and SOX3 mutations has been identified, the detailed etiology is multifactorial and unclear. Here, we present the case of a 7-year-old girl who was clinically diagnosed with SOD and 15q13.3 duplication. Patients with duplication at chromosome 15q13.3 were reported to be diagnosed with autism spectrum disorder, epilepsy, and schizophrenia in previous studies. The relationship between SOD and the microduplication of 15q13.3 has not yet been explored. In this study, we suggest that there may be an association between chromosome 15q13.3 microduplication and SOD.

Review articles

Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):190-199. Published online April 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00192

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Abstract PDF

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Citations

Citations to this article as recorded by

The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):200-205. Published online April 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00101

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Abstract PDF

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

Citations

Citations to this article as recorded by

A narrative review of pulsed radiofrequency for the treatment of carpal tunnel syndrome
Himanshu Gupta, Colm Vance, Vishal Bansal, Ahilraj Siva
Pain Practice.2024; 24(2): 374. CrossRef
Pulsed Radiofrequency for Auriculotemporal Neuralgia: A Case Report
Yan Tereshko, Enrico Belgrado, Christian Lettieri, Simone Dal Bello, Giovanni Merlino, Gian Luigi Gigli, Mariarosaria Valente
Neurology International.2024; 16(2): 349. CrossRef
Transforaminal pulsed radiofrequency and epidural steroid injection on chronic lumbar radiculopathy: A prospective observational study from a tertiary care hospital in Vietnam
Viet-Thang Le, Phuoc Trong Do, Vu Duc Nguyen, Luan Trung Nguyen Dao, Ipek Saadet Edipoglu
PLOS ONE.2024; 19(4): e0292042. CrossRef
Pulsed Radiofrequency Ablation for Refractory Cancer-Related Leg Pain: A Case Report
Praveen Reddy Elmati, Tyler J Wilkinson, Alexander Bautista
Cureus.2024;[Epub] CrossRef
Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain
Giusy Guzzi, Attilio Della Torre, Andrea Bruni, Angelo Lavano, Vincenzo Bosco, Eugenio Garofalo, Domenico La Torre, Federico Longhini
Journal of Anesthesia, Analgesia and Critical Care.2024;[Epub] CrossRef
Radiofrecuencia del nervio supraescapular como estrategia analgésica para el dolor crónico de hombro. Revisión sistemática y metaanálisis
J. Sebastián Infante, N. Blackburn, J. Felipe Vargas
Revista Española de Anestesiología y Reanimación.2024;[Epub] CrossRef
Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain
Shao‐jun Li, Dan Feng
CNS Neuroscience & Therapeutics.2023; 29(7): 1881. CrossRef
Previous Lumbar Spine Surgery Decreases the Therapeutic Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency in Patients with Chronic Lumbosacral Radicular Pain
Jiri Jandura, Milan Vajda, Roman Kostysyn, Jiri Vanasek, Eva Cermakova, Jan Zizka, Pavel Ryska
Journal of Personalized Medicine.2023; 13(7): 1054. CrossRef
Spinal Injections: A Narrative Review from a Surgeon’s Perspective
Dong Ah Shin, Yoo Jin Choo, Min Cheol Chang
Healthcare.2023; 11(16): 2355. CrossRef
Pulsed Radiofrequency 2 Hz Preserves the Dorsal Root Ganglion Neuron Physiological Ca2+ Influx, Cytosolic ATP Level, Δψm, and pERK Compared to 4 Hz: An Insight on the Safety of Pulsed Radiofrequency in Pain Management
Ristiawan Muji Laksono, Taufiq Agus Siswagama, Fa'urinda Riam Prabu Nery, Walter van der Weegen, Willy Halim
Journal of Pain Research.2023; Volume 16: 3643. CrossRef
Summary of the 48th KORSIS Symposium in 2023
Min Cheol Chang
International journal of Pain.2023; 14(2): 96. CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef
Use of QR Codes for Promoting a Home-Based Therapeutic Exercise in Patients with Lumbar Disc Herniation and Lumbar Spinal Stenosis: A Prospective Randomized Study
Min Cheol Chang, Donghwi Park, Yoo Jin Choo
Journal of Pain Research.2022; Volume 15: 4065. CrossRef

Communication

The pros and cons of entry restrictions: are entry restrictions really effective in preventing the spread of SARS-CoV-2?: Donghwi Park, Mathieu Boudier-Revéret, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(4):344-346. Published online January 14, 2022; DOI: https://doi.org/10.12701/yujm.2021.01599

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Abstract PDF

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide, leading the World Health Organization to declare coronavirus disease 2019 (COVID-19) a pandemic. To curb the unchecked spread of SARS-CoV-2 infection, most countries have enforced travel restrictions. However, it is debatable whether such restrictions are effective in containing infections and preventing pandemics. Rather, they may negatively impact economies and diplomatic relationships. Each government should conduct an extensive and appropriate analysis of its national economy, diplomatic status, and COVID-19 preparedness to decide whether it is best to restrict entering travelers. Even if travelers from other countries are allowed entry, extensive contact tracing is required to prevent the spread of COVID-19. In addition, governments can implement “travel bubbles,” which allow the quarantine-free flow of people among countries with relatively low levels of community transmission. An accurate evaluation of the benefits and losses due to entry restrictions during the COVID-19 pandemic would be helpful in determining whether entry restrictions are an effective measure to reduce the spread of infection in future pandemics.

Citations

Citations to this article as recorded by

“Exceptionally challenging time for all of us”: Qualitative study of the COVID-19 experiences of partners of diplomatic personnel
Samantha K. Brooks, Dipti Patel, Neil Greenberg, Joseph Adu
PLOS ONE.2023; 18(11): e0293557. CrossRef

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