View Single Post
Old 06-12-2007, 08:19 PM
artist
Guest
 
Posts: n/a
artist
Guest
 
Posts: n/a
Default

Hi Debbie,

What do all those medical college funds get spent on, huh? So...another doc in need of an education. Take some literature along to her. She can't argue with the movement disorder section in the clinical practice guidelines, I think, you'll find it at:
http://www.rsdfoundation.org/en/en_c...uidelines.html

and some very recent research:
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

Pain. 2007 May 11; [Epub ahead of print]
Onset and progression of dystonia in complex regional pain syndrome.
van Rijn MA, Marinus J, Putter H, van Hilten JJ.

Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

Complex regional pain syndrome (CRPS) may lead to movement disorders (MDs) in some patients. Reliable information on the nature, chronology and clinical determinants of MDs in CRPS patients is lacking but could provide better insight in to the underlying pathophysiological mechanism. We retrospectively evaluated the clinical and temporal characteristics of MDs in patients with CRPS. Cox's proportional hazards model was used to evaluate factors influencing the onset of MDs. One-hundred and eighty-five patients suffered CRPS in one or more extremities. MDs occurred in 121 patients, with dystonia (91%) being the most prevalent. Sixty-two percent of these patients displayed dystonia in multiple extremities. Patients with dystonia were on average 11years younger and more often had CRPS in multiple extremities. The interval between the onset of CRPS and dystonia in the first affected extremity varied from less than 1 week in 26% of the patients to more than 1year in 27%. The hazard of developing dystonia in subsequent extremities increased with the number of extremities affected by dystonia. We conclude that dystonia in CRPS shows highly variable onset latency and is associated with younger age at onset and increased risk of developing dystonia in other extremities. The delayed onset and progression of dystonia in CRPS may indicate the involvement of a different underlying mechanism, possibly associated with maladaptive neuroplasticity.

Also:
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum
Pain. 2006 Sep;124(1-2):184-9. Epub 2006 May 30.
Severity and specificity of neglect-like symptoms in patients with complex regional pain syndrome (CRPS) compared to chronic limb pain of other origins.
Frettlöh J, Hüppe M, Maier C.

The earlier research about neglect-like symptoms from 2000 is here (it kind of backs up the paper above):
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

Neglect-like symptoms in complex regional pain syndrome: results of a self-administered survey.
Galer BS, Jensen M.

If she doesn't like that (and docs do hate being wrong...) find another doc!
Sorry you have to go through this, it gets so tedious...sigh...
all the best
  Reply With QuoteReply With Quote