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Title: Conventional Lumbar Sympathectomy In The Treatment Of Recalcitrant Erythromelalgia
e-poster Number: INSIM77
Category: Pain
Author Name: Vinod Digraskar
Institute: Seth GSMC and KEMH,Mumbai
Co-Author Name: Dr Sweta Salgoankar, Dr Priti Devalkar, Dr Chhavi Khandelwal, Dr Amala Kudalkar
Abstract :
Erythromelalgia is an uncommon and difficult-to-treat disease characterized by bilateral burning pain in the limbs. It is frequently refractory and resistant to a variety of treatments. The pathogenesis of EM is yet unknown. Recent research has revealed sodium channelopathy as a hereditary etiology of many pain disorders. Method: A 23-year-old male with erythromelalgia was referred from dermatology with major symptoms of severe pain, edema and discoloration of skin over both the leg and sleeplessness. We explored many approaches starting with medicinal therapy with Amitryptiline-Pregabaline, Clonazepam,and others, including buprenorphine patch,but only 30 percent reduction in pain score. Secondly, epidural infusion due to the non-availability of a conventional RFA facility which gives some relief for a few days. Meanwhile, orally mexiletine i/v/o channelopathy and pentoxifylline were stated. Then Lignocaine infusion (with 5mg/kg over 1hr Loxicard 2%) and Ketamine infusion 0.5mg/kg/hr infusion on alternate days for 7 days given. Despite all these, no long-term benefit . Finally, conventional radiofrequency ablation given which was found to be very effective has not only reduced his pain but also make him mobile and avert him from the frequent pouring of water on his leg. The VAS Score (0-10) was assessed before the procedure and at 1 day, 1 week, 3 months, and 6 months after the procedure which shows a remarkable difference in pain score which reduced from 10 out of ten to 2 out of ten over six months. Conclusion: This case suggests the viability of Conventional radiofrequency treatment in patients with
