TY - JOUR
T1 - Bilateral burning foot pain
T2 - Monitoring of pain, sensation, and autonomic function during successful treatment with sympathetic blockade
AU - Galer, Bradley S.
AU - Lipton, Richard B.
AU - Kaplan, Ronald
AU - Kaplan, Jerry G.
AU - Arezzo, Joseph
AU - Portenoy, Russell K.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1991/2
Y1 - 1991/2
N2 - We describe a patient with burning pain in both feet associated with local autonomic disturbances following bilateral traumatic sciatic mononeuropathies. The diagnosis of a sympathetically maintained pain was confirmed through a prompt response to sympathetic blockade. Although a mild alcohol-nutritional neuropathy was found, the clinical findings strongly suggested a diagnosis of bilateral causalgia. Clinical evaluation and quantitative sensory testing were performed prior to and after successive unilateral lumbar sympathetic nerve blocks. After unilateral blockade, bilateral improvement was recorded in measures of pain, sudomotor function, and foot temperature. Other measures of autonomic function showed variable responses to sympathetic blockade. Quantitative sensory testing revealed a dramatic alteration in the contralateral limb's thermal sense following unilateral block. This case underscores the potential for bilateral causalgia and provides additional evidence for a central mechanism operating in this disorder. The relationship between bilateral causalgia and the "burning feet syndrome" in alcoholic neuropathy is discussed.
AB - We describe a patient with burning pain in both feet associated with local autonomic disturbances following bilateral traumatic sciatic mononeuropathies. The diagnosis of a sympathetically maintained pain was confirmed through a prompt response to sympathetic blockade. Although a mild alcohol-nutritional neuropathy was found, the clinical findings strongly suggested a diagnosis of bilateral causalgia. Clinical evaluation and quantitative sensory testing were performed prior to and after successive unilateral lumbar sympathetic nerve blocks. After unilateral blockade, bilateral improvement was recorded in measures of pain, sudomotor function, and foot temperature. Other measures of autonomic function showed variable responses to sympathetic blockade. Quantitative sensory testing revealed a dramatic alteration in the contralateral limb's thermal sense following unilateral block. This case underscores the potential for bilateral causalgia and provides additional evidence for a central mechanism operating in this disorder. The relationship between bilateral causalgia and the "burning feet syndrome" in alcoholic neuropathy is discussed.
KW - Causalgia
KW - burning feet syndrome
KW - quantitative sensory testing
KW - reflex sympathetic dystrophy
KW - sympathetically maintained pain
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U2 - 10.1016/0885-3924(91)90523-7
DO - 10.1016/0885-3924(91)90523-7
M3 - Article
C2 - 2007797
AN - SCOPUS:0025852367
SN - 0885-3924
VL - 6
SP - 92
EP - 97
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 2
ER -