Causalgia - severe pain, growing at traumas of peripheral nerve trunks, except when the injuries are the median and tibial nerves. Produce a number of symptoms characteristic of this syndrome: 1) the extreme intensity of pain, having the character of a painful burning sensation; 2) localization of pain in the skin, which tested a painful feeling of dryness; 3) the discrepancy of the pain is felt zone innervated by the struck nerve; so, with the defeat of the median nerve pain spread to the whole arm (hand, arm, shoulderand torso; 4) reduction of pain during cooling and increased by warming; 5) the difference between the extreme tenderness of the skin and lower sensitivity deep tissue. Most authors believe that the basis causalgia lies defeat sympathetic fibers that are included mentioned nerves.
Treatment. The pain somewhat calm down after wetting the skin, wet wrap - symptom "of a wet rag". Inside amidopyrine (pyramidonum) 0.25 g 3 times a day, chlorpromazine 0,025 g 2-4 times a day. Electrophoresis with novocaine. Debridement of the wound in the area of damaged nerve.
Surgical treatment causalgia may be conservative (procaine blockade) and operational (sympathectomy). With causalgia lower limbs in the area of the lumbar sympathetic ganglia enter 10-20 ml of 0.5% solution novokaina; causalgia upper limb novocaine enter in region II thoracic ganglion. Blockade repeat; each time the pain shot blockade resumes all later become less severe and sometimes completely stopped. If you repeat blockades pain resume with the same force, produce sympathectomy the above sites. Other operations (neurosis etc) with causalgia not effective and sometimes exacerbate pain.
Cm. also Blockade procaine, Sympathectomy.