Multiple reflex sympathetic dystrophy. Which patients are at risk for developing a recurrence of reflex sympathetic dystrophy in the same or another limb

Veldman, P.H.J.M.; Goris, R.J.A.

doi:10.1016/0304-3959(95)00160-3

Cited by 126 publications

(89 citation statements)

References 16 publications

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“…The pain expands along the limb and/or migrates to other body parts in nearly 70% of patients, and bilateral pain occurs in ϳ50% of cases (137). Indeed, the pain may expand to encompass a body quadrant or even the entire body (158,323). Such "anatomically impossible" patterns of pain led to the hypothesis that CRPS was of psychological rather than physical origin, but this explanation has been dismissed (363).…”

Section: Clinical Correlations: Complex Regional Pain Syndromes (Causmentioning

confidence: 99%

Beyond Neurons: Evidence That Immune and Glial Cells Contribute to Pathological Pain States

Watkins

Maier

2002

Physiological Reviews

656

433

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Chronic pain can occur after peripheral nerve injury, infection, or inflammation. Under such neuropathic pain conditions, sensory processing in the affected body region becomes grossly abnormal. Despite decades of research, currently available drugs largely fail to control such pain. This review explores the possibility that the reason for this failure lies in the fact that such drugs were designed to target neurons rather than immune or glial cells. It describes how immune cells are a natural and inextricable part of skin, peripheral nerves, dorsal root ganglia, and spinal cord. It then examines how immune and glial activation may participate in the etiology and symptomatology of diverse pathological pain states in both humans and laboratory animals. Of the variety of substances released by activated immune and glial cells, proinflammatory cytokines (tumor necrosis factor, interleukin-1, interleukin-6) appear to be of special importance in the creation of peripheral nerve and neuronal hyperexcitability. Although this review focuses on immune modulation of pain, the implications are pervasive. Indeed, all nerves and neurons regardless of modality or function are likely affected by immune and glial activation in the ways described for pain.

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Section: Clinical Correlations: Complex Regional Pain Syndromes (Causmentioning

confidence: 99%

Beyond Neurons: Evidence That Immune and Glial Cells Contribute to Pathological Pain States

Watkins

Maier

2002

Physiological Reviews

656

433

View full text Add to dashboard Cite

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“…129 In a study of 1,183 patients with nerve injury, it was found that the incidence of the initial onset of RSD (now called CRPS) was not correlated with age. 130 The median age of patients with single RSD was 41 and that of patients with multiple RSD was 35, although the median age of patients with recurrence of RSD was said to be lower. 130 In another study of 829 patients, it was found that there was no significant difference among age groups, with the exception that children under 10 years of age are less likely to develop CRPS.…”

Section: Challenges In Treatment Strategies For Neuropathic Pains: DImentioning

confidence: 99%

“…130 The median age of patients with single RSD was 41 and that of patients with multiple RSD was 35, although the median age of patients with recurrence of RSD was said to be lower. 130 In another study of 829 patients, it was found that there was no significant difference among age groups, with the exception that children under 10 years of age are less likely to develop CRPS. 131 Allen and colleagues found that the incidence of patients with CPRS was distributed over the ages of 18 -71 years with a mean of 41.8 years 132 The importance of the results of these population studies should be considered in the development of therapeutic strategies for the treatment of neuropathic pain.…”

Section: Challenges In Treatment Strategies For Neuropathic Pains: DImentioning

confidence: 99%

“…An examination of patients with PHN found that women were more sensitive than men to noxious heat. 129 Although it was reported that there was no statistical difference between men and women with regard to development of neuropathic pain after trauma, 130 referrals to pain clinics show a different story. The examination of medical records of 134 patients referred for treatment for CRPS showed a female to male ratio of 2.3-1.…”

Section: Challenges In Treatment Strategies For Neuropathic Pains: DImentioning

confidence: 99%

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Challenges in the development of novel treatment strategies for neuropathic pain

Ossipov

Porreca

2005

Neurotherapeutics

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Summary:Neuropathic pain might best be considered as a collection of various pain states with a common feature, that being symptoms suggestive of dysfunction of peripheral nerves. The development of therapeutic options for the treatment of neuropathic pain is complicated significantly by several factors. Neuropathic pain may arise from widely diverse etiologies such as physical trauma, disease, infection, or chemotherapy. Symptoms indicative of neuropathic pain may also arise in individuals with no evidence of any type of nerve trauma (idiopathic). Although neuropathic pain is a substantial health care issue, it is relatively uncommon and only occurs in a small fraction (Ͻ10%) of individuals with these initiating factors. Moreover, the efficacy of treatment protocols, even against the same type of symptoms, differ depending on the underlying initiating cause of the neuropathy. Although these observations strongly suggest that there are predisposing factors that may impart susceptibility to the development of neuropathic pain, no common predisposing factors or genetic markers have been satisfactorily identified. Because of these vagaries, treatment of neuropathic pain has been based on trial and error. However, recent progress in the understanding of neurophysiologic changes that accompany peripheral nerve dysfunction indicate that regulation of ion channels that maintain membrane potentials or generate action potentials may provide an important therapeutic approach. Neuropathic pain is accompanied by increased activity of peripheral nociceptors, which is produced in part by changes in levels of specific calcium and sodium channels. The identification of sodium and/or calcium channels subtypes that are expressed almost exclusively on nocicpetors may provide a way of regulating the activity of exaggerated nociceptor function without altering other sensory modalities. Thus, the selective targeting of ion channels may represent a viable therapeutic target for the management of the neuropathic pain state, regardless of etiology.

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“…Çocuklarda görülen KBAS'ın değerlendirildiği bir çalışmada, 70 hastanın 61'inde alt ekstremite tutulumu görülmüştür (13). Erişkinlerde alt ekstremitede gelişen KBAS etiyolojisi ile ilgili bir çalışmada, %73 neden travma, geriye kalan olgularda ise ayak operasyon öyküsü suçlanmıştır (14). Bir olgu sunumunda ise disk hernisi, kök lezyonu veya geçirilmiş diz protez operasyonu sonrasında gelişen bilateral alt ekstremite KBAS bildirilmiştir (15).…”

Section: Introductionunclassified

Hemiplejik Hastada Alt Ekstremitede Gelişen Kompleks Bölgesel Ağrı Sendromu: Bir Olgu Sunumu

Önder¹,

Selçuk²,

Kurtaran³

et al. 2011

Tftr

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ÖzetKompleks bölgesel ağrı sendromu (KBAS) tip 1 ekstremitede yanıcı ağrı, ödem, eklem hareket açıklığında kısıtlılık, vazomotor ve trofik değişiklikler ile karakterize bir tablodur. İnme sonrasında üst ekstremitede %20'lere varan oranlarda görülen bu sendrom alt ekstremitede oldukça nadirdir. Burada sol hemipleji nedeniyle takip edilen ve sol alt ekstremitesindeki ağrı nedeni ile yapılan değerlendirmeler sonucunda KBAS tip 1 tanısı alan 60 yaşında kadın hasta sunulmuştur. Hastanın tedaviside Transkütanöz Elektiriksel Sinir Sitimülasyonu (TENS), kalsitonin ve gabapentin kullanımı ile ağrıda azalma kaydedilmiştir. Erişkinlerde, inmeli hastalarda alt ekstremitede KBAS gelişimi oldukça nadirdir. Ancak bu hastalarda görülebilecek alt ekstremite ağrılarının ayrıcı tanısında mutlaka akılda tutulmalıdır. Türk Fiz T›p Re hab Derg 2011;57:245-7. Anah tar Ke li me ler: Kompleks bölgesel ağrı sendromu, inme, alt ekstremite Sum maryComplex regional pain syndrome (CRPS) type 1 is characterised by burning pain in the extremities, restriction in range of motion, vasomotor and trophic changes. This syndrome may be encountered after stroke in the upper extremity as much as in 20% of patients, but lower extremity involvement is rare. Herein, we present a 60-year-old female patient with left-sided hemiplegia who developed CPRS type 1 in her left lower extremity. The treatment of the patient involved Transcutaneous Electrical Nerve Stimulation (TENS), calcitonin and gabapentin which yielded decrease in pain. Lower extremity CRPS is extremely rare in adult patients, however, pain in the lower extremity should be considered in its differential diagnosis. Turk J Phys Med Re hab 2011;57:245-7.

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Multiple reflex sympathetic dystrophy. Which patients are at risk for developing a recurrence of reflex sympathetic dystrophy in the same or another limb

Cited by 126 publications

References 16 publications

Beyond Neurons: Evidence That Immune and Glial Cells Contribute to Pathological Pain States

Beyond Neurons: Evidence That Immune and Glial Cells Contribute to Pathological Pain States

Challenges in the development of novel treatment strategies for neuropathic pain

Hemiplejik Hastada Alt Ekstremitede Gelişen Kompleks Bölgesel Ağrı Sendromu: Bir Olgu Sunumu

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