Postdural Puncture Headache in Complex Regional Pain Syndrome: A Retrospective Observational Study
- 1 November 2009
- journal article
- Published by Oxford University Press (OUP) in Pain Medicine
- Vol. 10 (8), 1469-1475
- https://doi.org/10.1111/j.1526-4637.2009.00727.x
Abstract
To describe the unusual course of postdural puncture headache (PDPH) after pump implantation for intrathecal baclofen (ITB) administration in patients with complex regional pain syndrome (CRPS)-related dystonia. Case series based on data collected from 1996 to 2005. Setting. Movement disorders clinic, university hospital. A total of 54 patients with CRPS-related dystonia who were treated with ITB. A high incidence (76%) and prolonged course (median 18 days, range 2 days to 36 months) of PDPH was found. Radionuclide studies performed in two patients with long-lasting symptoms (12-16 months) did not reveal cerebrospinal fluid (CSF) leakage. In patients without signs of CSF leakage (N = 38), epidural blood patches administered in 24 patients were effective in 54%, while ketamine infusions administered in six patients were effective in 67%. Our observations may suggest that other mechanisms besides intracranial hypotension play a role in the initiation and maintenance of PDPH in CRPS and stimulate new directions of research on this topic.Keywords
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