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Function-limiting dysesthetic pain syndrome among traumatic spinal cord injury patients: a cross-sectional study
Authors:G Davidoff  E Roth  M Guarracini  J Sliwa  G Yarkony
Institution:1. Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor, MI 48109 U.S.A.;2. Department of Rehabilitation Medicine, Northwestern University Medical School, Chicago, IL 60611 U.S.A.;1. Simon Fraiser University, Burnaby, BC, Canada;2. Ecole de Technologie Superieure (ETS), Montreal, QC, Canada;3. University of Toronto, Toronto, ON, Canada;4. McGill University, Montreal, QC, Canada;5. Western University, London, ON, Canada;6. London Health Sciences Centre, London, ON, Canada;1. Emory University School of Medicine, Atlanta, Georgia, USA;2. Department of Neurosurgery, Emory University, Atlanta, Georgia, USA;1. School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia;2. Mater Pharmacy Services, Mater Health Services, South Brisbane, QLD, Australia;3. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia;4. Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
Abstract:Diffuse burning dysesthetic sensations distal to the level of spinal injury are the most common and disabling painful sequelae of traumatic spinal cord injury (SCI). In a cross-sectional study of 19 SCI patients, clinical characteristics and results of 3 validated pain measurement instruments (McGill Pain Questionnaire, Sternbach Pain Intensity and Zung Pain and Distress Scale) were used to develop a profile of function-limiting dysesthetic pain syndrome (DPS). Compared to a cohort of 147 patients admitted to the Midwest Regional Spinal Cord Injury Care System during the time period of the study, subjects were more likely to have paraplegia, incomplete sensory myelopathy, gunshot wounds to the spine and non-surgical spinal stabilization. Most patients described the pain as 'cutting,' 'burning,' 'piercing,' 'radiating' and 'tight.' The majority of patients located the pain internally and in the lower extremities. Values obtained from 6 McGill Pain Questionnaire subscales, 2 Sternbach Pain Intensity ratings and the Zung Pain and Distress index equalled or exceeded those reported for other pain syndromes. Use of these validated pain measures resulted in a systematic comprehensive assessment of function-limiting DPS following SCI.
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