Evidence map›Paper›PMID 29953015›Full record

ArticleMedicine2018

Extrapyramidal signs occurring after sympathetic block for complex regional pain syndrome responding to diphenhydramine: Two case reports.

Semih Gungor, Rohit Aiyer

Registry-linked trialOpen access · goldAbstract readCase Reports
In one paragraph

Article in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05693337 (Infrared), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05693337 completednot on this mapstarted 2023, after this paper: background citation

Infrared (FLIR) Imaging as a Monitor for Sympathetic Blocks in Complex Regional Pain Syndrome (CRPS)

TypeobservationalSponsorHospital for Special Surgery, New YorkRan2023 to 2023Enrolled30ConditionsComplex Regional Pain SyndromesArmsForward Looking Infrared Radar (FLIR) thermal imaging
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 7 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 2 countries.

Semih GungorDivision of Pain Medicine, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery-Weill Cornell Medicine, Cornell University Department of Psychiatry, Hofstra Northwell Health-Staten Island University Hospital, Staten Island, New York.
Rohit Aiyer
Apple (Israel) · ILHospital for Special Surgery · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleTo present an unusual extrapyramidal motor response occurring after a sympathetic block in CRPS and its successful treatment with diphenhydramine. PATIENT CONCERNS: Severe pain related to Complex Regional Pain Syndrome type 1 interfering with activities of daily living. DIAGNOSES: Complex Regional Pain Syndrome type 1.

interventionsWe report a video case reports of two patients with a diagnosis of CRPS type-I. Both patients exhibited similar presentation of unusual extrapyramidal motor response of the affected limb following lumbar sympathetic block. Both patients were treated with intravenous diphenhydramine to abort the extrapyramidal motor response. OUTCOMES: Both patients similarly responded to treatment with intravenous diphenhydramine with abrupt resolution of the motor response. LESSONS: Sympathetic blockade may interfere with the adaptive autonomic reflex circuits of the motor balance homeostasis in patients with complex regional pain syndrome. Disinhibition of extrapyramidal system may lead to immediate expression of extrapyramidal signs following the sympathetic block. Diphenhydramine, with its anti-histaminic and anticholinergic properties, may be effective in aborting such extrapyramidal signs, and should be considered as a treatment option in similar cases.

Indexed as

AdultAutonomic Nerve BlockDiphenhydramineFemaleHistamine H1 AntagonistsHumansReflex Sympathetic DystrophyYoung AdultDiphenhydramineHistamine H1 Antagonists

Identifiers

PMID29953015
PMCPMC6039649
OpenAlexW2810492247

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.