Therapeutic Effect of Pamidronate on the Post-Stroke ReflexSympathetic Dystrophy.

, Sohn, Min Kyun; , Kim, Bong Ok; , Lee, Tae Sung; , Jee, Sung Ju

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2008;32(6):651-656.

Sohn, Min Kyun , Kim, Bong Ok , Lee, Tae Sung , Jee, Sung Ju

Department of Rehabilitation Medicine, College of Medicine, Brain Research Institute, Chungnam National University, Korea. drjeesungju@cnuh.co.kr

뇌졸중 후 반사성 교감신경 이영양증에서 파미드로네이트의 효과

손민균, 김봉옥, 이태성, 지성주

충남대학교 의과대학 재활의학교실, 뇌과학연구소

Abstract

Objective
To evaluate the effects of pamidronate on post- stroke reflex sympathetic dystrophy (RSD).
Method
Twenty four subacute stroke patients who fulfilled Kozin's criteria of RSD were enrolled in this study. Mixed with 500 ml of 5% glucose saline, 60 mg of pamidronate was intravenously administered daily for 3 consecutive days to make total dose of 180 mg. Clinical scores of the pain and swelling and the circumference of the middle finger were measured just before, 1 and 2 weeks after the injections. Three phase bone scintigraphy and bone densitometry (BMD) were performed before and 2 weeks after pamidronate injections.
Results
Clinical scores of the pain and swelling and the circumference of the middle finger improved significantly after pamidronate injections. The ratio of radioisotope uptake decreased in both blood pool and delayed phase images. BMD of ultradistal radius of the involved arm significantly increased after pamidronate injections. Eleven subjects developed fever or myalgia. Two subjects could not complete the injections due to severe allergic skin reaction.
Conclusion
The intravenous pamidronate injection could be an effective therapeutic tool for post-stroke RSD. (J Korean Acad Rehab Med 2008; 32: 651-656)

Key Words: Reflex sympathetic dystrophy, Stroke, Hemiplegia, Pamidronate