Der Schmerz
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Pain medicine as an interdisciplinary, multifaceted field has not yet been assigned the status of a separate medical subject in the curriculum of medical schools in Germany. Pain medicine is often taught by anesthesiologists, neurologists, orthopedic or neurological surgeons either by assignment by the Dean’s office or because of their own enthusiasm. In the near future pain medicine as an interdisciplinary course will be mandatory in undergraduate medical education. The authors were interested to investigate the needs and demands of both students and instructors from theoretical and clinical fields in order to develop a longitudinal pain medicine curriculum. ⋯ At the Hannover Medical School, a standardized needs assessment helped to develop LoMoS, the longitudinal pain medicine curriculum, which may also serve as a model for other medical faculties. Students required more practical instruction and teachers were interested in improving networking and discussion among specialists.
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Next to neurogenic inflammation and pathological sympathetic-afferent coupling, functional imaging studies have shown the crucial role of maladaptive cortical reorgansation in the pathophysiology of CRPS. Bilateral neuroplastic alterations in the somatosensory cortex seem to play a substantial role in the dysfunctional sensory processing of stimuli. The aim was to investigate the multimodal integration of sensory and visual stimuli into the body scheme and the influence of higher cognitive body representation in the integration of multimodal schema, body relevant stimuli in patients with CRPS. ⋯ The rubber hand illusion was carried out for the first time in patients with complex regional pain syndrome (CRPS). The reprentations show that the patients can integrate a rubber hand in their body representation to the same degree as healthy patients. The intact experience of the rubber hand illusion by CRPS patients indicates that the integration of congruent visual and tactile stimuli in CRPS is intact.