{"title":"Sympathetic Fiber Sprouting in Chronically Compressed Dorsal Root Ganglia Without Peripheral Axotomy.","authors":"Shelby Q Chien, Chunling Li, Huiqing Li, Wenrui Xie, Carmelita S Pablo, Jun-Ming Zhang","doi":"10.1300/J426v01n01_05","DOIUrl":"https://doi.org/10.1300/J426v01n01_05","url":null,"abstract":"<p><p>Sympathetic axonal sprouting in axotomized dorsal root ganglia (DRG) has been shown to be a major phenomenon implicated in neuropathic pain. However, it is not known whether sympathetic sprouting can occur in pathologic ganglia without peripheral axotomy. We thus examined presence and density of sympathetic axonal sprouting within DRG of rats subjected to a persistent compressive injury by inserting a stainless steel metal rod into L(4) and L(5) lumbar intervertebral foramen. Sympathetic axons were identified by immunohistochemical staining with anti-tyrosine hydroxylase antibodies. Results indicate that progressive increase in sympathetic axonal sprouting occurred in the bilateral DRGs between postoperative days 2 and 28. The sympathetic fiber density was greater on the lesion side than the contralateral side. In conclusion, chronic compressive injury of the DRG results in sympathetic sprouting in the non-axotomized ganglion and may partially contribute to the development and maintenance of certain pathological pain states.</p>","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"1 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1832160/pdf/nihms13084.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26627699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Complex Regional Pain Syndrome","authors":"Yong Chul Kim","doi":"10.3344/KJP.2004.17.S.S104","DOIUrl":"https://doi.org/10.3344/KJP.2004.17.S.S104","url":null,"abstract":"Complex regional pain syndrome (CRPS) is a challenging pain condition with incompletely elucidated pathophysiology, most often affecting a single extremity after an inciting injury. The most common clinical finding is burning pain out of proportion to any identifiable initiating event, with a combination of sensory, vasomotor, sudomotor, and motor/trophic signs and symptoms. The management of CRPS emphasizes early diagnosis and aggressive multimodal treatment based on physical therapy, psychological therapy, and pain management with frequent reassessments of patient progression. In order to prevent permanent life-altering disability, all modalities including interventional therapies should be escalated in tandem, based on assessments of patient responsiveness. Clinicians should consider escalating therapy frequently if no improvement is observed, and introducing psychological evaluation if symptoms persist. Lastly, the use of interventional techniques such as sympathetic blocks or spinal cord stimulation should be employed early in refractory cases.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89540586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}