Problems of diagnosis and treatment of chronic pain syndrome in patients with variants of the structure of peripheral nerves. A series of clinical cases
- Authors: Bulatov A.R.1, Kolesnik T.A.1, Boykova А.A.1, Litvinenko I.V.1, Tsygan N.V.2
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Affiliations:
- Military Medical Academy
- Kirov Military Medical Academy
- Issue: Vol 42, No 4 (2023)
- Pages: 413-420
- Section: Case report
- URL: https://journal-vniispk.ru/RMMArep/article/view/264752
- DOI: https://doi.org/10.17816/rmmar615774
- ID: 264752
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Abstract
AIM: To assess the presence of variants of the structure of peripheral nerves as possible risk factors for chronic pain syndrome on the example of a series of clinical cases.
MATERIALS AND METHODS: The systematization and analysis of data from domestic and foreign literature on pathophysiology, clinic, diagnosis and treatment of complex regional pain syndrome has been carried out. Research method: system analysis, presentation of a series of clinical cases.
RESULTS: A series of clinical cases is presented. The main risk factors for chronic pain syndrome are presented. The conditions and diseases that need to be differentially diagnosed if complex regional pain syndrome is suspected are systematized: tunnel syndromes (carpal tunnel syndrome), diabetic polyneuropathy, HIV polyneuropathy, postherpetic neuralgia, neurogenic claudication/lumbar stenosis, central post-stroke pain, upper thoracic syndrome apertures.
CONCLUSION: Today, practitioners and neurophysiologists are not sufficiently aware of the existence of interneural anastomoses and features, typical electroneuromyographic signs, as a result of which in most cases the obtained electroneuromyographic data are interpreted erroneously. Variants of the structure of nerves can give an incorrect clinical picture of the condition of peripheral nerves and lead to untimely diagnosis and treatment of chronic pain syndrome, complex regional pain syndrome. Improvements in diagnostic methods, as well as widely introduced high-tech examination methods, in particular electroneuromyography, magnetic resonance imaging and ultrasound, are helping to increase the frequency of detection of abnormalities in the structure of peripheral nerves. In the presented clinical cases, patients had structural variants that gave an incorrect clinical picture of the condition of the peripheral nerves and led to untimely diagnosis and treatment — the development of chronic pain syndrome.
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##article.viewOnOriginalSite##About the authors
Al'bert R. Bulatov
Military Medical Academy
Author for correspondence.
Email: albert_br@mail.ru
ORCID iD: 0000-0001-7180-4389
SPIN-code: 1626-8400
Lecturer of the Nervous Diseases Department
Russian Federation, Saint PetersburgTatyana A. Kolesnik
Military Medical Academy
Email: taniakolesnik061@mail.ru
student of the 4th faculty, 5th year
Russian Federation, Saint PetersburgАлександра A. Boykova
Military Medical Academy
Email: saboykova@yandex.ru
SPIN-code: 3191-4308
student of the 4th faculty, 5th year
Russian Federation, Saint PetersburgIgor' V. Litvinenko
Military Medical Academy
Email: litvinenkoiv@rambler.ru
ORCID iD: 0000-0001-8988-3011
SPIN-code: 6112-2792
Scopus Author ID: 35734354000
ResearcherId: F-9120-2013
M.D., D.Sc. (Medicine), Professor the Head of the Department and Clinic of Nervous Diseases
Russian Federation, Saint PetersburgNikolay V. Tsygan
Kirov Military Medical Academy
Email: 1860n@mail.ru
ORCID iD: 0000-0002-5881-2242
SPIN-code: 1006-2845
Scopus Author ID: 37066611200
ResearcherId: H-9132-2016
M.D., D.Sc. (Medicine), Professor, Deputy Head of the Department and Clinic of Nervous Diseases
Russian Federation, Saint PetersburgReferences
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