Complex Regional Pain Syndrome in Remission 6 years


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 Complex Regional Pain Syndrome

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Celebrating six years of complete remission

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Why ketamine should never be used alone

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I first posted her case here. 

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For years, pain below both knees was 8 to 9 on scale of 10, “like I had swallowed a fire burning.”

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She was unable to stand or walk for more than 4 years before seeing me. This week, I again saw this very healthy athletic RN who at almost 70 of age is very youthful, very energetic. She failed IV ketamine given first by Dr. Schwartzman daily for one week, then boosters for 8 months.

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After 8 months of ketamine, then no response at all. None. 

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That’s when I prescribed other glial modulators and rational polypharmacy that brought CRPS into remission. Then very very slowly tapered off all but one, leaving only low dose naltrexone (LDN) for the last 8 years. Zero pain. None. Hiking, working, fully active.

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When used in conditions with known neuro-inflammation, rats or human, LDN is a one of the most powerful, most effective glial modulators I have ever seen clinically in my patients in the last 15 years.

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Until proven otherwise clinically, LDN should be taken lifelong in those cases.

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This website is not for email.

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The advertising is not approved by me and

unrelated to anything on these pages.

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The material on this site is for informational purposes only, and

is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Protein critical for neuromuscular junction modulates glutamate


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Protein critical for neuromuscular junction

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Lrp4 in astrocytes modulates glutamatergic transmission

Published online June 13 2016

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“We found that glutamate release in the brain was impaired in mice lacking low-density lipoprotein receptor–related protein 4 (Lrp4), a protein that is critical for neuromuscular junction formation.”

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Could this relate to POTS which improves with mestinon? or chronic fatigue of so many conditions (CRPS, fibromyalgia, Lyme Disease)?

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As reported in Neuroscience News

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“In the neuromuscular juncture, Mei’s lab found several years back that LRP4 on the muscle cell surface is a receptor for agrin, a protein that motor neurons release to direct construction of the nerve-muscle juncture. His lab later identified antibodies to LRP4 and agrin as new causes of myasthenia gravis. The new research indicates that release of ATP by astrocytes is also regulated by agrin signaling.”

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…”When you take LRP4 out of astrocytes, ATP levels released by those astrocytes go super high, which suppresses glutamate transmission,” Mei said.

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“Now it’s clear that glial cells, like astrocytes, have a role in neurodevelopment and longer-term in regulating communication between two neurons.”

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Original Research from the Medical College of Georgia: by Xiang-Dong Sun, Lei Li, Fang Liu, Zhi-Hui Huang, Jonathan C Bean, Hui-Feng Jiao, Arnab Barik, Seon-Myung Kim, Haitao Wu, Chengyong Shen, Yun Tian, Thiri W Lin, Ryan Bates, Anupama Sathyamurthy, Yong-Jun Chen, Dong-Min Yin, Lei Xiong, Hui-Ping Lin, Jin-Xia Hu, Bao-Ming Li, Tian-Ming Gao, Wen-Cheng Xiong and Lin Mei in Nature Neuroscience

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This website is not for email.

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The advertising is not recommended by me

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