Abstract

We present two patients with type-1 complex regional pain syndrome (CRPS) and one patient with post-herpetic neuralgia (PHN) patients whose pain had failed to respond to standard pain treatment, but was resolved by electroconvulsive therapy (ECT). To investigate the potential role of regional cerebral blood flow (rCBF) involved in ECT's analgesic effect, we measured significant changes in the rCBF in the thalamus before and after a course of bilateral ECT using technetium-99m ethyl cysteinate dimer (99mTc ECD) single photon emission computed tomography (SPECT). SPECT showed significantly decreased rCBF in the thalamus which increased after ECT. The results of SPECT suggest that ECT increases abnormally decreased thalamus activity in chronic neuropathic pain. Our results from the SPECT suggest that these rCBF changes may be related to the analgesic efficacy of ECT.

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