Utility of Electrical Neuromodulation for Treating Chronic Pain Syndromes in the Pediatric Setting: A Systematic Review

Karri, Jay; Palmer, Jeremé Sharíf; Charnay, Aaron; Garcia, Carol; Orhurhu, Vwaire; Shah, Shalini; Abd‐Elsayed, Alaa

doi:10.1111/ner.13365

Cited by 8 publications

(7 citation statements)

References 37 publications

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Section: Epidemiologymentioning

confidence: 99%

“…It is important to note that CRPS is not a diagnosis exclusive to adults but there is certainly a paucity of evidence in regards to diagnosis and treatment of the pediatric population [ 13 ]. A 2021 systematic review by Karri et al focuses CRPS in the pediatric population and it considers neuromodulation, a known treatment modality in adults, for pediatric patients [ 13 ]. The primary goals of treatment of CRPS in the pediatric population are pain relief and improving all domains of functioning in order to improve the patient’s quality of life [ 14 ].…”

Section: Epidemiologymentioning

confidence: 99%

“…Therapy includes intensive physical therapy combined with cognitive behavioral therapy intervention [ 14 ]. Among other treatments in the standard of care approach, pediatric patients may be considered for neuromodulation interventions, such as spinal cord stimulation (SCS) or dorsal root ganglion stimulation (DRG) devices [ 13 ]. Karri et al recommend careful consideration of pubertal growth spurt prior to device lead placement given the possibility of inferior lead migration with physiologic growth in patients with SCS devices or foraminal extrusion in patients with DRG devices [ 13 ].…”

Section: Epidemiologymentioning

confidence: 99%

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Complex Regional Pain Syndrome: A Comprehensive Review

et al. 2021

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Complex regional pain syndrome (CRPS) is a chronic pain condition often involving hyperalgesia and allodynia of the extremities. CRPS is divided into CRPS-I and CRPS-II. Type I occurs when there is no confirmed nerve injury. Type II is when there is known associated nerve injury. Female gender is a risk factor for developing CRPS. Other risk factors include fibromyalgia and rheumatoid arthritis. Unfortunately, the pathogenesis of CRPS is not yet clarified. Some studies have demonstrated different potential pathways. Neuropathic inflammation, specifically activation of peripheral nociceptors of C-fibers, has been shown to play a critical role in developing CRPS. The autonomic nervous system (ANS) is involved. Depending on whether it is acute or chronic CRPS, norepinephrine levels are either

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Complex Regional Pain Syndrome: A Comprehensive Review

et al. 2021

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“…The treatment for CRPS is mainly dealt symptomatically with a combination of physical/occupational therapies, psychological therapy, neuropathic pain medications, antiinflammatories and interventional procedures. 37 Karri et al, 18 published a systematic study in 2021 that focuses on CRPS in children and explores neuromodulation, a well-known therapy option for adults, for pediatric patients. In the pediatric population, the key aims of CRPS therapy are pain reduction and improvement in all areas of functioning to enhance the patient's life quality.…”

Section: Discussionmentioning

confidence: 99%

Treatment Modalities of Complex Regional Pain Syndrome After Hand Surgery a Systematic Review and Meta-Analysis Study

mahmoud¹,

Hamza²,

Zayid³

2022

Al-Azhar International Medical Journal

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Background: complex regional pain syndrome is a complex medical condition. Physical/occupational treatments, psychiatric counseling, neuropathic pain medicines, anti-inflammatories, and surgical intervention are utilized to treat complex regional pain syndrome (CRPS). Aim of the study: The aim of this work is to do meta-analysis study of complex regional pain syndrome treatment modalities after hand surgery in most recent literatures. Patients and Methods: After full-text screening 12papers were included in this systemic review and meta-analysis.This research was conducted and reported following PRISMA (for systematic review and metaanalysis recommended reporting items). From 2016 to 2021. Results: 10 studies showed Responders with a high event in bisphosphonate than in Ketamine study with highly significant heterogeneity among included studies p-value 0.0005. 12 studies were included 6 studies showed adverse events with highly significant heterogeneity p-value <0.0001. Conclusion:Although there has yet to be good therapy for CRPS, years of study have taught us a lot about the disorder and our knowledge of it is still growing. Furthermore, in comparison to CRPS type I, the evidentiary foundation for CRPS type II is limited. As a result, further research is required to determine which patient subgroups might benefit the most from presently available treatments. Because of the syndrome's complexity, focusing on a single mechanism is unlikely to be beneficial. Therapy combination, like with other chronic disorders, maybe the future of CRPS management, and research into this will be required.

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“…Not only do the newer units provide paresthesia-free or minimal-paresthesia analgesia, but they have been demonstrated through myriad systematic reviews to be safe, clinically effective, and even cost-effective in treating neuropathic pain of axial spine or radicular origin, as well as radicular symptoms, in addition to other types of neuropathic pain across different populations. [10][11][12][13][14][15][16][17][18][19][20][21][22] While SCS has been a treatment option for chronic pain for only half a century, accounts of the use of opioids date back to at least 1550 BC, when an ancient Egyptian pharmacopoeia contained prescriptions for uses of opium. 23 Although effective as analgesics for many types of pain, opioids' efficacy for neuropathic pain has been determined to be extremely limited, at best.…”

mentioning

confidence: 99%