RSD Puzzle #037

H. Hooshmand, M. D.

DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY

BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY

BOARD CERTIFIED IN ELECTROMYOGRAPHY

BOARD CERTIFIED IN AMERICAN BOARD OF ELECTODIAGNOSTIC MEDICINE

INTRACTABLE NEUROLOGY

EPILEPSY, PAIN, MS

An International Referral Center dedicated to Treatment, Education and Research

RSD PUZZLE #37
"EVER SINCE I WAS AFFECTED BY RSD I HAVE SUFFERED FROM IRREGULAR, PAINFUL, AND HEAVY MENSTRUAL PERIODS. CAN THIS BE RELATED TO RSD?"

There are two main factors that RSD results in painful and irregular and heavy menstrual periods.

1. The visceral inflammation which is typical of RSD. In RSD the surface skin is cold and as the skin becomes deprived of proper blood flow, the blood flowing deep structures (bone, muscle, guts, and pelvis) increases with resultant inflammation of the deep structures. This is manifested in symptoms such as abdominal pains, pelvic inflammatory disease (PID), irregular, heavy, and painful menstruation, and attacks of persistent coughing. In the later stages of RSD, spontaneous attacks of abdominal pain, diarrhea, and weight loss may develop as well.

2. Sympathetic nerve blocks, especially over the lumbar sympathetic chain, or over the coeliac ganglion are quite effective to correct these problems. The alpha II blocker, Yohimex (Yohimbine) which is used for enhancement of erection, functions by reversing the cold and pale skin circulation, and as a result, the visceral deep structure inflammation is alleviated. Other sympathetic blocks such as Clonidine skin patch and oral Ketamine may be quite helpful. The attacks of diarrhea may be relieved with the help of the use of elixir of paregoric and tincture of belladonna. The later complication of attacks of diarrhea and weight loss is especially seen among patients who have been the victim of lightning strike.

H. Hooshmand, M.D.

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