is CRPS medically classified as a Mental Condition or Neurological???

bobinjeffmo · 12-19-2010, 10:57 AM

I would appreciate you keeping me posted on how you're doing both physically and legally. Between the two, I'm not the right one to ask which one is worse. Now just hang onto that great attitude of yours and try and not let corrupt people and the physical damage become your entire life. Even though we certainly live differently, it doesn't mean there's not a whole lot of life to live. Now go find some joy in the season! Bob.

Quote:

Originally Posted by CarlaDanDan

Thank you so much Bob for your words and contribution here
yes its a battle, sometimes a war!
battle with lawyers
battle with doctors to get right treatment
and between those stages you described i get very, very upset with these people (doctors and lawyers of mine, i know out there theres good ones), but luckily i've got lots lots of patience
but i keeping fight, even being a mere patient without a medical or law diploma! Im reviewing his report and making changes that i am not happy. So hopefully he will re-write this wrong (kind of insulting) prognosis
I will let you know
take care
lots of love

fmichael · 12-20-2010, 12:31 AM

Hi there. For what it's worth, there is now fairly convincing proof that, once established - that is, beyond the point of remission - CRPS is maintained by a "thalamocortical dysrhythmia," which is to say a disruption/displacement of the oscillatory brain waves that define our experience. And the same is true of any number of conditions, Parkinson’s disease, depression, tinnitus, etc. And each has its unique pattern.

The article that’s taken the pain community for a loop (pun intended) came out of the laboratory of Rodolfo R. Llinás, who has been the chairman of the Department of Neuroscience at NYU for 34 years and (I am told) is widely regarded as one of the leading neuroscientists in the world. What the following Commentary in Pain by Edward Jones alludes to is that these concepts had been floating around for the last decade in the neurophysiology (EEG) literature, by were not picked up by the pain community until the NYU team specifically set its sights on CRPS.

Here it is: Walton KD, Dubois M, Llinás RR, Abnormal thalamocortical activity in patients with Complex Regional Pain Syndrome (CRPS) Type I, Pain 2010 Jul;150(1):41-51, FULL ONLINE TEXT @ http://www.rsds.org/2/library/articl..._Pain_2010.pdf:

Abstract
Complex Regional Pain Syndrome (CRPS) is a neuropathic disease that presents a continuing challenge in terms of pathophysiology, diagnosis, and treatment. Recent studies of neuropathic pain, in both animals and patients, have established a direct relationship between abnormal thalamic rhythmicity related to Thalamo-cortical Dysrhythmia (TCD) and the occurrence of central pain. Here, this relationship has been examined using magneto-encephalographic (MEG) imaging in CRPS Type I, characterized by the absence of nerve lesions. The study addresses spontaneous MEG activity from 13 awake, adult patients (2 men, 11 women; age 15-62), with CRPS Type I of one extremity (duration range: 3months to 10years) and from 13 control subjects. All CRPS I patients demonstrated peaks in power spectrum in the delta (<4Hz) and/or theta (4-9Hz) frequency ranges resulting in a characteristically increased spectral power in those ranges when compared to control subjects. The localization of such abnormal activity, implemented using independent component analysis (ICA) of the sensor data, showed delta and/or theta range activity localized to the somatosensory cortex corresponding to the pain localization, and to orbitofrontal-temporal cortices related to the affective pain perception. Indeed, CRPS Type I patients presented abnormal brain activity typical of TCD, which has both diagnostic value indicating a central origin for this ailment and a potential treatment interest involving pharmacological and electrical stimulation therapies.

PMID: 20338687 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/20338687

It’s pretty tough sledding though. The Commentary published with it is more accessible. Jones EG, Thalamocortical dysrhythmia and chronic pain, Pain 2010 Jul; 150(1):4-5, Epub 2010 Apr 14, FULL ONLINE TEXT @ http://www.rsds.org/2/library/articl..._Pain_2010.pdf

An earlier thread on this ran in August, in the context of Deep Brain Stimulation, especially for people with horrible dystonia: DBS (Deep Brain Stimulation) for RSD and Dystonia http://neurotalk.psychcentral.com/sh...d.php?p=685104

It's funny, but it appears that - essentially out of nowhere - the CNS aspects of CRPS/RSD have suddenly been laid bare for all to see.

Mike

cindi1965 · 12-20-2010, 04:33 AM

Quote:

Originally Posted by CarlaDanDan

Thank you for your opinions!!! i also believed that pain is something real, and i agree that therapy helps to cope, but unfortunately didnt make it yet to magically disappear my pain.
I am in England, and did not have a MRI since got injuried, never visited a neurologist (NHS cutting costs

). I had an EMG looong time ago, that showed Peroneal complications... I also received RF denervation. I have little information from doctor about my true diagnosis, except that talk in the past at Pain Clinic. Really learning from Internet, leaflets and support groups.

The symptoms at right lower leg, most concentrated on the foot, include stiffness, extreme temperatures sometimes is burning hot and some days like today is icing freezing cold, the nerve pain, pins and needles and constant numbness. Very poor circulation, lacks mobility, the swelling is low most of days, and sometimes i get cramps. My balance is bad, i describe my walking as a duck one! Since the accident there was improvements on sensations, moves, skin colour, pain and sweeling, all lessen, but still present and no improvements anymore, for two years now.

Im on Gabapentin 300mg and Tramadol 50mg 4 times a day. They can help to control the pain, but the stiffness never goes away and temperature is always different than good foot. I reduced my tablets with the help of weekly acupuncture sections (i highly recommend acupuncture to everyone who suffer with Pain). This winter pain and coldness is worsening and im question myself if i did right in reducing...
I will see a GP next 30th and will ask for referral to Pain Management (but i doubt he will give me) Its a lotery get appointments with specialist here. It was told me that to acess a private doctor is very expensive.

sorry for the long message, every help is very welcome
thank you for your support and patience in reading
lots of love

Try asking for Baclofen for your stiffness. I have Cerebral Palsy and I have been taking it for years. I don't have the stiffness that other people have with their RSD. I was diagnosed 2 and a half years ago. It's too bad that you haven't seen a neurologist, because that is key with CRPS/RSD diagnosis, however I no longer see my neuro, because my GP does a better job at controlling my symptoms as he has MS.

Dubious · 12-20-2010, 01:17 PM

Quote:

Originally Posted by CarlaDanDan

Hello out there!
hope you are all well
I have Peripheral Neuropathy and CRPS on my right foot injuried on a car accident 4 years ago.
I've been to Pain Management Team, on that time, when i was diagnosed and i remember the doctor explaining about my symptoms and treatment, and she said that medication would help, but also i could help myself psychologically (tapping to her head). Since them I've been trying my best in keep up, working on regenerate my nerve damaged and recover from Post Trauma.

Yesterday i had to review a legal medical report from a Psychiatrist about my Mental Health for Court

On the report he wrote about the Prognosis of my Chronic Pain and state that in his opinion he would expect a significant degree of recovery such that I can return to a fairly normal level of function within 9 months of the commencement of treatment...

sorry if my question sounds nonsense, i am not an expert

Please, do you know if Chronic Pain is a Mental Health Condition???,
i thought that was a Neurological Disorder? well, i am a layperson about my own condition, I never had opportunity to visit a Neurologist and i've been learning from Internet and from the little input of Doctors here in UK. "Health Studies" and our bodies are soooo complex to understand...we patients need help and information.
I would be greatfuly if you could comment about it and give your opinion too, also if you have experienced such a quickly recovery i would be more inspired. I really hope that he is right about timing

thanks in advance
lots of love

Hi,

I have not looked at prior replies so sorry if this is a repeat. ICD-9 codes are what (US) physicians use to catagorize diseases and conditions. They are usually lumped into "series" of types of diagnosis. Examples for CRPS are as follows (there are others):

355.9 Mononeuritis of unspecified site
Causalgia NOS
Complex regional pain syndrome NOS
Excludes:
causalgia:
lower limb (355.71)
upper limb (354.4)
complex regional pain syndrome:
lower limb (355.71)
upper limb (354.4)

354.4 Causalgia of upper limb
Complex regional pain syndrome type II of the upper limb
Excludes:
causalgia:
NOS (355.9)
lower limb (355.71)
complex regional pain syndrome type II of the lower limb (355.71)

337.20 Reflex sympathetic dystrophy, unspecified
Complex regional pain syndrome type I, unspecified

The general "series" is:

354 Mononeuritis of upper limb and mononeuritis multiplex

355 Mononeuritis of lower limb

337 Disorders of the autonomic nervous system
Includes: disorders of peripheral autonomic, sympathetic, parasympathetic, or vegetative system
Excludes: familial dysautonomia [Riley-Day syndrome] (742.8)

Regarding pain:

338 Pain, not elsewhere classified
Use additional code to identify:
pain associated with psychological factors (307.89)
Excludes:
generalized pain (780.96)
headache syndromes (339.00-339.89)
localized pain, unspecified type - code to pain by site
migraines (346.0-346.9)
pain disorder exclusively attributed to psychological factors (307.80)
vulvar vestibulitis (625.71)
vulvodynia (625.70-625.79)

338.29 Other chronic pain

338.21 Chronic pain due to trauma

338.4 Chronic pain syndrome
Chronic pain associated with significant psychosocial dysfunction

So using ICD-9 indexing, CRPS would be classified as a neurological disorder, whether these codes make sense or not, at least by the AMA. There are of course, various psychological complications in some cases.

Hope this helps!

Similar Threads
Thread	Thread Starter	Forum	Replies	Last Post
New artcile on gluten sensitivity as neurological condition--	glenntaj	Gluten Sensitivity / Celiac Disease	4	12-23-2011 01:59 PM
New paper on gluten sensitivity as neurological condition--	glenntaj	Peripheral Neuropathy	9	11-25-2010 02:05 PM
what IS mental health? or mental illness? NEUROLOGICAL? or "just in your head"?	OneMoreTime	Community & Forum Feedback	4	12-11-2006 09:25 AM

Site Navigation

NeuroTalk Online Support Groups

is CRPS medically classified as a Mental Condition or Neurological???

NeuroTalk Forums