May 23, 2008
Eight years ago a 20-year-old female from Tennessee USA developed CRPS following an injury to the right upper extremity. Despite aggressive treatment with medications and sympathetic nerve blocks (which provided partial relief of the patient's pain) her symptoms became progressively worse preventing her from attending school. In addition, CRPS symptoms spread to the right lower extremity and right face region.
The graph below illustrates that following a series of right stellate ganglia blocks, which were followed immediately by the administration of escalating doses of IV ketamine over three consecutive days, there was normalization of pain thresholds. This was accomplished as an outpatient. The following video shows that the patient had significant functional improvements after the 3-day ketamine treatment and suggests that patients who have sympathetically maintained pain (SMP) might obtain additional benefit from ketamine infusions. Side effects are discussed:
Subsequently, the patient experienced exacerbation and spreading of CRPS as a result of physical trauma caused by a reflex hammer used by a physician during an independent medical examination (IME). The incident is discussed in the 6-minute video linked above and is evident in the pain thresholds below:
Measurement of Pain Thresholds .... Learn more
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