tailieunhanh - Báo cáo y học: "Gabapentin for complex regional pain syndrome in Machado-Joseph disease: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Gabapentin for complex regional pain syndrome in Machado-Joseph disease: a case report. | Lo et al. Journal of Medical Case Reports 2011 5 268 http content 5 1 268 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Gabapentin for complex regional pain syndrome in Machado-Joseph disease a case report Yang-Ching Lo Kwong-Kum Liao Yi-Chung Lee and Bing-Wen Soong Abstract Introduction Chronic pain is a common problem for patients with Machado-Joseph disease. Most of the chronic pain in Machado-Joseph disease has been reported to be of musculoskeletal origin but now there seems to be different chronic pain in patients with Machado-Joseph disease. Case presentation A 29-year-old man Han Chinese Hoklo with Machado-Joseph disease experienced severe chronic pain in both feet cutaneous thermal change thermal hypersensitivity focal edema and sweating and had a history of bone fracture. These symptoms were compatible with a diagnosis of complex regional pain syndrome. After common analgesics failed to relieve his pain gabapentin was added and titrated to 2000 mg day 500 mg every six hours in less than two weeks. This relieved 40 of his pain and led to significant clinical improvement. Conclusions The pathophysiology of complex regional pain syndrome includes peripheral and central sensitizations the latter of which might be associated with the neurodegeneration in Machado-Joseph disease. In this report we suggest that gabapentin could inhibit central sensitization as an adjunct for complex regional pain syndrome in patients with Machado-Joseph disease. Introduction Machado-Joseph disease MJD also called spinocerebellar ataxia type 3 is the most common subtype of spinocerebellar ataxias worldwide and is caused by a CAG trinucleotide repeat expansion in the coding region of the MJD1 gene. The main features of MJD are ataxia and ophthalmoparesis and pyramidal extrapyramidal and amyotrophic signs 1 . Chronic pain is one of the most disabling symptoms of MJD. Nearly 80 of the chronic pain in MJD has been reported to be of musculoskeletal