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Propranolol for Causalgia

Carol P. Magee; Hanus J. Grosz, MD
JAMA. 1974;228(7):826-827. doi:10.1001/jama.1974.03230320014009.
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To the Editor.—  Simson has recently reported (227:327, 1974) that the administration of 240 mg of propranolol hydrochloride per day in divided doses caused dramatic improvement of causalgia affecting the lower limbs. Marked subjective and objective improvement was noted in two cases within 12 and 48 hours, respectively, thus making it unnecessary for the patients to undergo sympathectomy.We have been unable to replicate the favorable effect of propranolol on causalgia in a recently treated case. Our patient was a 43-year-old veteran who was admitted to the hospital for sympathectomy to relieve severe and incapacitating causalgia in the left upper limb of six months' duration, the result of an injury to his left hand sustained in a fall. The affected hand, wrist, and forearm were painful, markedly swollen, cold, and tender to touch. On the dorsum of the lower forearm and wrist were chronic trophic ulcers. The hand and fingers


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