Der Schmerz
-
Disability is a central aspect in the assessment of chronic pain patients. Disability questionnaires in German (developed or adapted) are examined and selected for different purposes. The "Funktionsfragebogen Hannover" and the "Pain Disability Index" are recommended for both research and clinicalapplication while the "Sickness Impact Profile" is suitable only for research purposes. ⋯ There are some empirical data for three of them. Only the "Inventory of Familial Adaptability and Cohesion" has achieved a certain degree of empirical maturity. Further research and developmental activity in this area of pain assessment are urgently needed.
-
Introduction Spinal epidural abscess is a rare cause of neurological disability, which is frequently, preceded by local spinal pain. There are only a few case series in the literature and the prognosis for this disease has not improved significantly over the past 50 years. Patients and methods Seven patients were treated neurosurgically with laminectomy and abscess drainage for spinal epidural abscesses from 1991 to 1994. ⋯ Elevated blood sedimentation rates in conjunction with local pain of the vertebral column should direct attention to the possibility of an epidural abscess. Magnetic resonance imaging is the radiological technique of choice for establishment of the diagnosis. Conventional X-rays are of no value for early diagnosis because neurological signs and symptoms precede bony changes of the vertebrae.
-
Pain therapy with epidural or intrathecal catheters is an invasive method. These techniques have specific indications in both acute and chronic pain therapy. However, complications can occur. ⋯ Monitoring: During treatment with spinal catheters, adequate monitoring increases safety for the patients. Efficacy of the injections, puncture site and the neurological status should be documented daily. Neurological deficits must be diagnosed without losing time and adequate therapy must be initiated.
-
The present article is a case report on a chronic sympathetically maintained pain syndrome following a mild lesion of the brachial plexus. Apart from slight motor and sensory disturbances, which disappeared within a few months, no autonomic, motor or sensory deficit remained. ⋯ In the climax of the pain attacks it became manifest like a mirror reflexion on the opposite side. The diagnostic and therapeutic problems that occurred during these years and the dependency of the pain attacks on exterior influences are evaluated.