Postdural Puncture Headache in Complex Regional Pain Syndrome: A Retrospective Observational Study. Pain medicine (Malden, Mass.) [Pain Med] Journal article | | Title | Postdural Puncture Headache in Complex Regional Pain Syndrome: A Retrospective Observational Study. | | Author(s) | Munts AG, Voormolen JH, Marinus J, Delhaas EM, van Hilten JJ | | Institution | Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. | | Source | Pain Med 2009 Oct 23. | | Abstract | ABSTRACT
Objective. To describe the unusual course of postdural puncture headache (PDPH) after pump implantation for intrathecal baclofen (ITB) administration in patients with complex regional pain syndrome (CRPS)-related dystonia. Design. Case series based on data collected from 1996 to 2005. Setting. Movement disorders clinic, university hospital. Patients. A total of 54 patients with CRPS-related dystonia who were treated with ITB.
Results. A high incidence (76%) and prolonged course (median 18 days, range 2 days to 36 months) of PDPH was found. Radionuclide studies performed in two patients with long-lasting symptoms (12-16 months) did not reveal cerebrospinal fluid (CSF) leakage. In patients without signs of CSF leakage (N = 38), epidural blood patches administered in 24 patients were effective in 54%, while ketamine infusions administered in six patients were effective in 67%.
Conclusions. Our observations may suggest that other mechanisms besides intracranial hypotension play a role in the initiation and maintenance of PDPH in CRPS and stimulate new directions of research on this topic. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19863745 |
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