Tonic dystonia: an uncommon complication of reflex sympathetic dystrophy syndrome. A review of five cases

Morelet, Aude; Gagneux-Lemoussu, Laurence; Brochot, P.; Ackah-Miezan, Stanley; Colmet-Daage, J. F.; Boyer, Françoise; Eschard, Jean-Paul; Etienne, J

doi:10.1016/j.jbspin.2005.01.002

Cited by 15 publications

(5 citation statements)

References 7 publications

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“…In severe cases, the spectrum of symptoms is often broad and includes sensory disturbances, tactile, thermal and pain anesthesia, progressive motor impairment and dystonic posturing [2][3][4] . Though most patients respond to medications and physiotherapy, some are considered to be refractory.…”

Section: Introductionmentioning

confidence: 99%

Pain Relief and Functional Recovery in Patients with Complex Regional Pain Syndrome after Motor Cortex Stimulation

Fonoff

Hamani²,

Andrade

et al. 2011

Stereotact Funct Neurosurg

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In addition to pain and neurovegetative symptoms, patients with severe forms of complex regional pain syndrome (CRPS) develop a broad range of symptoms, including sensory disturbances, motor impairment and dystonic posturing. While most patients respond to medical therapy, some are considered refractory and become surgical candidates. To date, the most commonly used surgical procedure for CRPS has been spinal cord stimulation. This therapy often leads to important analgesic effects, but no sensory or motor improvements. We report on 2 patients with pain related to CRPS and severe functional deficits treated with motor cortex stimulation (MCS) who not only had significant analgesic effects, but also improvements in sensory and motor symptoms. In the long term (27 and 36 months after surgery), visual analog scale pain scores were improved by 60–70% as compared to baseline. There was also a significant increase in the range of motion in the joints of the affected limbs and an improvement in allodynia, hyperpathia and hypoesthesia. Positron emission tomography scan in both subjects revealed that MCS influenced regions involved in the circuitry of pain.

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Section: Introductionmentioning

confidence: 99%

Pain Relief and Functional Recovery in Patients with Complex Regional Pain Syndrome after Motor Cortex Stimulation

Fonoff

Hamani²,

Andrade

et al. 2011

Stereotact Funct Neurosurg

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“…CRPS affects not only afferent sensory systems; efferent motor pathways are also hampered, which leads to clinical signs of a decreased range of motion, involuntary movements, and dystonia 46,47 . Postsynaptic motor reflex inhibition was found impaired in CRPS patients 48 .…”

Section: Pathogenesis and Etiologymentioning

confidence: 99%

Current Understandings on Complex Regional Pain Syndrome

Mos

Sturkenboom

Huygen³

2009

Pain Practice

139

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Abstract:The mechanisms underlying complex regional pain syndrome (CRPS) have been increasingly studied over the past decade. Classically, this painful and disabling disorder was considered to emerge from pathology of the central nervous system. However, the involvement of additional peripheral disease mechanisms is likely, and recently these mechanisms have also attracted scientific attention. The present article provides an overview of the current understandings regarding pathology of the autonomic and somatic nervous system in CRPS, as well as the roles of neurogenic inflammation, hypoxia, and the contribution of psychological factors. Potential connections between the separate disease mechanisms will be discussed. Additionally, currently known risk factors for CRPS will be addressed. Insight into risk factors is of relevance as it facilitates early diagnosis and tailored treatment. Moreover, it may provide clues for further unraveling of the pathogenesis and etiology of CRPS.

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“…Quelquefois une absence de sensibilité au toucher contraste avec la présence d'une douleur sévère dans la même zone algodystrophique (anaesthesia dolorosa). Certains patients se plaignent de contracture musculaire après essai d'efforts, de tremblements de l'extrémité affectée, de petits mouvements cloniques rythmiques des doigts, de signes d'incoordination musculaire [36][37][38]. Il est assez fréquent que soit présent aussi un « syndrome de négligence du membre algodystrophique », le patient ressent sa main algodystrophique comme étrangère à lui-même [39].…”

Section: Autres Formes Symptomatiquesunclassified