The Clinical journal of pain
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The goal was to study the utility of nonverbal facial expressions as a research tool for assessing pain in persons with intellectual disabilities. Biases and stereotypes related to age, gender, physical attractiveness, and intellectual disability that may influence the ability of observers to evaluate pain reactions were also examined. ⋯ The findings support the validity of both objectively coded and observer-rated facial expressions of pain as research tools in treatment outcome studies involving persons with intellectual disabilities. Self-report has substantial limitations for the assessment of pain in this population.
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Nine patients with Complex Regional Pain Syndrome types I and/or II (CRPS), previously known as reflex sympathetic dystrophy (RSD) and causalgia, respectively, were selected for treatment with a continuous four to eight week subcutaneous infusion of 10% lidocaine. ⋯ Five patients completed the infusion treatment. The treatment significantly alleviated much of the pain and other symptomatology (i.e., dysesthesia, allodynia, hyperpathia, color and temperature changes, decreased range of motion of involved extremities, changes in hair and nail growth, etc.) commonly observed for CRPS/RSD patients. Upon discontinuation of the continuous subcutaneous infusion, patients appear to maintain the pain relief obtained. Periodic maintenance infusions may be needed.