CRPS & Trigeminal Neuralgia

Question 1

CRPS affects upper limbs more than lower limbs in…

Answer 1

adults

Question 2

CRPS affects lower limbs more than upper limbs in…

Answer 2

children

Question 3

What is hyperalgesia?

Answer 3

Increased sensitivity to pain

Question 4

What is allodynia?

Answer 4

Pain from a stimulus that is not normally painful

Question 5

How does Type I CRPS differ from Type 2?

Answer 5

Type 1 - no evidence of nerve damage; used to be called RSD

Type 2 - evidence of nerve damage; used to be called causalgia

Question 6

What is the clinical diagnostic criteria for CRPS?

Answer 6

• Continuing pain which is disproportionate to any inciting event
• 1 symptom in 3 of 4 categories:
  Sensory: hyperesthesia and/or allodynia
  Vasomotor: temp or skin color asymmetry
  Sudomotor/edema: edema or sweating changes
  Motor/trophic: decreased ROM or motor dysfunction

Question 7

Spinal cord stimulator

Answer 7

• Electrode placed in epidural space over the dorsal column structure a few levels above the affected spinal segment
• Electrical pulses are delivered to the spinal cord to cause parasthesias in the region

Question 8

What are the clinical features of trigeminal neuralgia?

Answer 8

Sudden, unilateral, evere, recurrent episodes of pain in the distribution of one or more branches of the trigeminal nerve. Pain occurs in paroxysms, does not awaken patients in the night and precipitated by light touch.

Question 9

What are the causes of trigeminal neuralgia?

Answer 9

Idiopathic, compression of trigeminal nerve root, compression by an aberrant loop of an artery or vein.

Question 10

What are some treatment options for trigeminal neuralgia?

Answer 10

• Anticonvulsants
• Microvascular decompression-craniotomy
• Rhizotomy
• Gamma knife radiosurgery

Question 11

What is spinal facilitation?

Answer 11

Maintenance of a pool of neurons in a state of partial or sub threshold excitation; in this state, less afferent stimulation is required to trigger the discharge of impulses.