PhD ceremony Ms. M.I. Bodde: Complex regional pain syndrome type 1 & amputation
|We 19-02-2014 at 14:30
|Academiegebouw, Broerstraat 5, Groningen
PhD ceremony: Ms. M.I. Bodde
Dissertation: Complex regional pain syndrome type 1 & amputation
Promotor(s): prof. J.H.B. Geertzen, prof. P.U. Dijkstra
Faculty: Medical Sciences
Complex Regional Pain Syndrome type I (CRPS-I) is characterized by severe pain in the distal part of an extremity that may develop spontaneously or after a noxious event. The intensity of the pain is disproportionate to the inciting event. The pathophysiology of CRPS-I is (still) unknown. Patients with CRPS-I may require long, intensive treatment (in accordance with national or international guidelines). In a small number of patients, the syndrome is therapy-resistant and persists for months or years. The dysfunctional limb may cause difficulties with daily life activities and the ability to work. After long series of failed treatment some of these patients request an amputation of the affected limb as a last resort therapy.
This thesis aims at providing evidence for clinicians who are faced with requests for amputation from patients who are affected by CRPS-I. What is known in the literature on beneficial and adverse effects of amputation in case of CRPS-I is described and discussed in a systematic review. Furthermore, the impact of an amputation on pain, participation in daily life activities, and quality of life is described. We studied the association between resilience and post-amputation outcome of patients amputated because of CRPS-I, and aspects of the process of informed decision making in amputation for CRPS-I. Lastly, results from histopathological research on nerve tissue from the CRPS-I affected amputated limbs are described.