Premium
CAUSALGIC SYNDROMES
Author(s) -
Macfarlane W. V.
Publication year - 1949
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1949.tb03644.x
Subject(s) - medicine , sympathectomy , etiology , neurotomy , anesthesia , procaine , surgery , itching , spinal cord , psychiatry
Summary1 The etiology of post‐traumatic pain states (causalgic syndromes) is reviewed. Evidence favours: (a) The production, by a peripheral focus of injury in a nerve, of sustained discharges from cord neuron pools. These would result in widespread pain, with sensory, motor, sympathetic and trophic disturbances. (b) Fibre interaction between sympathetic or other efferents and the somatic afferent fibres, at the site of injury, feeding the irritable internuncial neuron pool. 2 Twenty‐one cases of various types of syndrome are described and classified. Aching, as well as burning pains, occurs in both major and minor causalgias and in painful amputation stumps. Transitions from one pain type to another are recorded. 3 No single Fiurgical approach will afford relief in all cases of causalgia. In thisseries five patients were permanently relieved by local infiltration of procaine into tender areas or the sympathetic chain. The others required neurotomy, sympathectomy or chordotomy. Only two of eight patients in whose treatment sympathectomy was employed had permanent relief. 4 Causalgia as a complicafion of elective surgical procedures involving nerves or spinal cord was encountered in five cases.