{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:31:25Z","timestamp":1760189485451},"reference-count":10,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2015,9,18]],"date-time":"2015-09-18T00:00:00Z","timestamp":1442534400000},"content-version":"unspecified","delay-in-days":7445,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. j. neurol. sci."],"published-print":{"date-parts":[[1995,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0317167100040233_abs1\"><jats:title>Background:<\/jats:title><jats:p>Some patients with reflex sympathetic dystrophy (RD) develop intractable symptoms unresponsive to conventional therapy. Recently, intrathecal morphine therapy has been used with some success in such patients.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100040233_abs2\"><jats:title>Methods:<\/jats:title><jats:p>The clinical course of two patients with intractable reflex sympathetic dystrophy (RSD) is described. Both patients developed intractable leg pain, swelling and autonomic changes after a leg injury. Numerous medical treatments and surgical sympathectomies failed to provide long term relief.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100040233_abs3\"><jats:title>Results:<\/jats:title><jats:p>Relatively satisfactory symptom control was achieved only with the use of long term intrathecal morphine therapy delivered by subcutaneously implanted infusion pumps. Exacerbations of the RSD continued to occur, at times in association with further leg trauma, but these could be controlled by a temporary escalation of the intrathecal morphine dose. Complications of morphine therapy were relatively minor. A red rash appearing over the pump site was the first sign that a drug catheter break had occurred, necessitating surgical catheter revision.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100040233_abs4\"><jats:title>Conclusion:<\/jats:title><jats:p>Long term intrathecal morphine therapy is a useful treatment option for patients with intractable severe RSD who have failed other therapies and remain markedly disabled.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0317167100040233","type":"journal-article","created":{"date-parts":[[2016,2,17]],"date-time":"2016-02-17T04:22:31Z","timestamp":1455682951000},"page":"153-159","source":"Crossref","is-referenced-by-count":22,"title":["Long Term Treatment of Intractable Reflex Sympathetic Dystrophy With Intrathecal Morphine"],"prefix":"10.1017","volume":"22","author":[{"given":"W.J.","family":"Becker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.P.","family":"Ablett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.J.","family":"Harris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.N.","family":"Dold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,9,18]]},"reference":[{"key":"S0317167100040233_ref428","first-page":"89","article-title":"Morphine and substance P release in the spinal cord","volume":"82","author":"Mortin","year":"1990","journal-title":"Exp Brain Res"},{"key":"S0317167100040233_ref427","doi-asserted-by":"publisher","DOI":"10.1016\/0166-2236(92)90019-5"},{"key":"S0317167100040233_ref422","first-page":"425","article-title":"Treatment of lower extremity reflex sympathetic dystrophy with continuous intrathecal morphine infusion. Proceedings of the meeting of the American Society for Stereotactic and Functional Neurosurgery","volume":"50","author":"Goodman","year":"1987","journal-title":"Montreal, Appl Neurophysiol"},{"key":"S0317167100040233_ref419","unstructured":"International Association for the Study of Pain. Classification of Chronic Pain: Description of Chronic Pain Syndromes and Definitions of Pain Terms. Prepared by a Sub-Committee on Taxonomy. Pain, Suppl. 3, 1986."},{"key":"S0317167100040233_ref424","first-page":"135","article-title":"Sensitized nociceptors in reflex sympathetic dystrophy","volume":"4","author":"Marchettini","year":"1989","journal-title":"Funct Neurol"},{"key":"S0317167100040233_ref421","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880161002"},{"key":"S0317167100040233_ref420","first-page":"401","article-title":"Reflex sympathetic dystrophy syndrome: a review","volume":"10","author":"Kozin","year":"1992","journal-title":"Clin Exp Rheumatol"},{"key":"S0317167100040233_ref423","first-page":"160","volume":"1993","author":"Hooshmand"},{"key":"S0317167100040233_ref426","doi-asserted-by":"publisher","DOI":"10.1016\/0166-2236(93)90133-7"},{"key":"S0317167100040233_ref425","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/112.3.621"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167100040233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,13]],"date-time":"2019-05-13T18:39:11Z","timestamp":1557772751000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167100040233\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,5]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1995,5]]}},"alternative-id":["S0317167100040233"],"URL":"https:\/\/doi.org\/10.1017\/s0317167100040233","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,5]]}}}