MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor
Background. Causalgia is continuing pain, allodynia, or hyperalgesia after nerve injury with edema, changes in skin blood flow, or abnormal sudomotor activity. Here we report a case of lower extremity causalgia following elective transsphenoidal resection of a pituitary tumor in a young man. Clinica...
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Wiley
2012-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/598048 |
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| author | D. Ryan Ormond Augustine L. Moscatello Raj Murali |
| author_facet | D. Ryan Ormond Augustine L. Moscatello Raj Murali |
| author_sort | D. Ryan Ormond |
| collection | DOAJ |
| description | Background. Causalgia is continuing pain, allodynia, or hyperalgesia after nerve injury with edema, changes in skin blood flow, or abnormal sudomotor activity. Here we report a case of lower extremity causalgia following elective transsphenoidal resection of a pituitary tumor in a young man. Clinical Presentation. A 33-year-old man with acromegaly underwent elective sublabial transsphenoidal resection of his pituitary tumor. During the three-hour surgery, the lower limbs were kept in a supine, neutral position with a pillow under the knees. The right thigh was slightly internally rotated with a tape to expose fascia lata, which was harvested to repair the sella. Postoperatively, he developed causalgia in a distal sciatic and common peroneal nerve distribution. Pain was refractory to several interventions. Finally, phenoxybenzamine improved his pain significantly. Conclusions. Malpositioning in the operating room resulted in causalgia in this young man. Phenoxybenzamine improved, and ultimately resolved, his symptoms. Improvement in his pain symptoms correlated with resolution of imaging changes in the distal sciatic and peroneal nerves on the side of injury. |
| format | Article |
| id | doaj-art-2c982dc40e754cc0adf04045408c49be |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
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| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-2c982dc40e754cc0adf04045408c49be2025-02-03T06:11:14ZengWileyCase Reports in Neurological Medicine2090-66682090-66762012-01-01201210.1155/2012/598048598048MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary TumorD. Ryan Ormond0Augustine L. Moscatello1Raj Murali2Department of Neurosurgery, New York Medical College, Munger Pavilion, Third Floor, Valhalla, NY 10595, USADepartment of Otolaryngology, New York Medical College, Valhalla, NY 10595, USADepartment of Neurosurgery, New York Medical College, Munger Pavilion, Third Floor, Valhalla, NY 10595, USABackground. Causalgia is continuing pain, allodynia, or hyperalgesia after nerve injury with edema, changes in skin blood flow, or abnormal sudomotor activity. Here we report a case of lower extremity causalgia following elective transsphenoidal resection of a pituitary tumor in a young man. Clinical Presentation. A 33-year-old man with acromegaly underwent elective sublabial transsphenoidal resection of his pituitary tumor. During the three-hour surgery, the lower limbs were kept in a supine, neutral position with a pillow under the knees. The right thigh was slightly internally rotated with a tape to expose fascia lata, which was harvested to repair the sella. Postoperatively, he developed causalgia in a distal sciatic and common peroneal nerve distribution. Pain was refractory to several interventions. Finally, phenoxybenzamine improved his pain significantly. Conclusions. Malpositioning in the operating room resulted in causalgia in this young man. Phenoxybenzamine improved, and ultimately resolved, his symptoms. Improvement in his pain symptoms correlated with resolution of imaging changes in the distal sciatic and peroneal nerves on the side of injury.http://dx.doi.org/10.1155/2012/598048 |
| spellingShingle | D. Ryan Ormond Augustine L. Moscatello Raj Murali MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor Case Reports in Neurological Medicine |
| title | MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor |
| title_full | MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor |
| title_fullStr | MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor |
| title_full_unstemmed | MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor |
| title_short | MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor |
| title_sort | mri findings of causalgia of the lower extremity following transsphenoidal resection of pituitary tumor |
| url | http://dx.doi.org/10.1155/2012/598048 |
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