Revista de la Sociedad Española del Dolor
versión impresa ISSN 1134-8046
GARRIDO-SUAREZ, B. et al. Usefulness of Mangifera Indica L (Vimang®) in the treatment of Complex Regional Pain Syndrome (CRPS): A case report. Rev. Soc. Esp. Dolor [online]. 2007, vol.14, n.7, pp.494-500. ISSN 1134-8046.
Advances in our understanding of Complex Regional Pain Syndrome (CRPS) physiopathology have led to new drugs targeted toward molecular mediators involved in the complex mechanisms of pain. Neuroinflammation is thought to have an active role in phenomena underlying spinal cord dorsal horn hyperexcitability and the establishment of central sensitivity. An extract from the bark of selected Mangifera indica L species, registered under the Vimang® Trade Mark in Cuba, has antioxidant, anti-inflammatory and antihyperanalgesic activity in vivo. In Vitro studies have demonstrated that it has an inhibitory effect on several molecules mediating the central sensitization cascade and an ischemic-reperfusion model has proved its cerebral neuroprotective qualities. We present a patient with type II CRPS secondary to a brachial plexus lesión following a displaced left humerus fracture that sectioned the radius nerve. The patient presented in our pain clinic four months after the accident with sensorial symptoms, persistent burning pain mechanical allodynia, oedema, vasomotor alterations tending to hyperhaemia and a flexed hand due to loss of the motor function in the fore arm extensors. Carpal and shoulder Joint movement was severely limited and she scored 5 on the Likert pain scale. Electrophysiological study revealed mild myelin-axonal alterations in the median nerve and severe alterations in the radial nerve. Treatment with Vimang (300 mg; 2 tablets/8 hours/4 months) with topical administration of Vimang cream 3 times per day combined with sympathetic and somatic nerve blocks in the upper limb and physiotherapy were begun. The patient's clinical and electrophysiological evolution was very favourable. This is the first description of the use of this product in combined CRPS therapy. Our results indicate that further basic and clinical research into the use of Vimang® for CRPS is Justified.
Palabras clave : Complex Regional Pain Syndrome; neuropathic pain; Vimang®.