[Shoulder-hand syndrome in patients after stroke]. 1999

A Zyluk, and B Zyluk
Kliniki Chirurgii Ogólnej i Chirurgii Reki, Szczecinie.

Basing on the literature, the information on the shoulder-hand syndrome in stroke patients is presented. The syndrome is believed to be a clinical form of algodystrophy of the upper extremity. The main signs and symptoms include pain and considerable reduction of movement in shoulder joint, wrist and hand. The condition usually develops 1-6 months after stroke with pain and loss of range of motion in the shoulder at the beginning; then the distal part of the extremity is involved. The syndrome is considered to develop in three consecutive phases: I--acute, II--dystrophic and III--atrophic. Besides classical clinical form, affecting distal and proximal part of extremity, the incomplete forms confined only to one of this parts may exist. The prevalence of the condition is rated at 12.5-27% in stroke patients. It is believed that the development of the syndrome is related to altered biomechanics of the hemiplegic shoulder. Stability of the joint is considerably affected due to paresis or palsy of shoulder girdle muscles what results in partial subluxation of humeral head. Repeated microtraumas of shoulder joint may cause chronic pain and may initiate development of abnormal, regional sensory-sympathetic reflex arch, or--according to the other concept--it results in "sensitization" of neurons in the dorsal horn; this state may alter dorsal horn central mechanisms processing sensory and painful stimuli. The diagnosis of the syndrome is based on clinical ground. Three-phase bone scintigraphy is believed to be the most useful additional diagnostic test. The diagnostic and predictive value of this technique is presented. For all advantages of scintigraphic examination, it does not need to be performed in the majority of stroke patients since the presence of typical signs and symptoms is usually sufficient to make a diagnosis. The treatment of shoulder-hand syndrome included administration of steroids with satisfactory response. The role of proper physical therapy in improving of the results of treatment as well as in prophylactics of the syndrome is emphasised. Considering the fact that many of stroke patients may have contraindications to steroid therapy, other methods of effective treatment are proposed.

UI MeSH Term Description Entries
D011877 Radionuclide Imaging The production of an image obtained by cameras that detect the radioactive emissions of an injected radionuclide as it has distributed differentially throughout tissues in the body. The image obtained from a moving detector is called a scan, while the image obtained from a stationary camera device is called a scintiphotograph. Gamma Camera Imaging,Radioisotope Scanning,Scanning, Radioisotope,Scintigraphy,Scintiphotography,Imaging, Gamma Camera,Imaging, Radionuclide
D012019 Reflex Sympathetic Dystrophy A syndrome characterized by severe burning pain in an extremity accompanied by sudomotor, vasomotor, and trophic changes in bone without an associated specific nerve injury. This condition is most often precipitated by trauma to soft tissue or nerve complexes. The skin over the affected region is usually erythematous and demonstrates hypersensitivity to tactile stimuli and erythema. (Adams et al., Principles of Neurology, 6th ed, p1360; Pain 1995 Oct;63(1):127-33) Algodystrophy,Complex Regional Pain Syndrome, Type I,Pain Syndrome Type I, Regional, Complex,Shoulder-Hand Syndrome,Sudek Atrophy,Algodystrophic Syndrome,CRPS Type I,Cervical Sympathetic Dystrophy,Pain Syndrome Type I, Complex Regional,RSD (Reflex Sympathetic Dystrophy),Reflex Sympathetic Dystrophy Syndrome,Sudek's Atrophy,Sympathetic Reflex Dystrophia,Syndrome, Reflex Sympathetic Dystrophy,Type I Complex Regional Pain Syndrome,Algodystrophies,Atrophies, Sudek's,Atrophy, Sudek,Atrophy, Sudek's,CRPS Type Is,Cervical Sympathetic Dystrophies,Dystrophies, Cervical Sympathetic,Dystrophies, Reflex Sympathetic,Dystrophy, Cervical Sympathetic,Dystrophy, Reflex Sympathetic,RSDs (Reflex Sympathetic Dystrophy),Reflex Dystrophia, Sympathetic,Reflex Sympathetic Dystrophies,Shoulder Hand Syndrome,Shoulder-Hand Syndromes,Sudek's Atrophies,Sudeks Atrophy,Sympathetic Dystrophies, Cervical,Sympathetic Dystrophies, Reflex,Sympathetic Dystrophy, Cervical,Sympathetic Dystrophy, Reflex,Sympathetic Reflex Dystrophias,Syndrome, Algodystrophic,Syndrome, Shoulder-Hand,Syndromes, Shoulder-Hand,Type I, CRPS
D002561 Cerebrovascular Disorders A spectrum of pathological conditions of impaired blood flow in the brain. They can involve vessels (ARTERIES or VEINS) in the CEREBRUM, the CEREBELLUM, and the BRAIN STEM. Major categories include INTRACRANIAL ARTERIOVENOUS MALFORMATIONS; BRAIN ISCHEMIA; CEREBRAL HEMORRHAGE; and others. Brain Vascular Disorders,Intracranial Vascular Disorders,Vascular Diseases, Intracranial,Cerebrovascular Diseases,Cerebrovascular Insufficiency,Cerebrovascular Occlusion,Brain Vascular Disorder,Cerebrovascular Disease,Cerebrovascular Disorder,Cerebrovascular Insufficiencies,Cerebrovascular Occlusions,Disease, Cerebrovascular,Diseases, Cerebrovascular,Insufficiencies, Cerebrovascular,Insufficiency, Cerebrovascular,Intracranial Vascular Disease,Intracranial Vascular Diseases,Intracranial Vascular Disorder,Occlusion, Cerebrovascular,Occlusions, Cerebrovascular,Vascular Disease, Intracranial,Vascular Disorder, Brain,Vascular Disorder, Intracranial,Vascular Disorders, Brain,Vascular Disorders, Intracranial
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor

Related Publications

A Zyluk, and B Zyluk
November 2001, Archives of physical medicine and rehabilitation,
A Zyluk, and B Zyluk
December 2005, Europa medicophysica,
A Zyluk, and B Zyluk
February 2009, Bosnian journal of basic medical sciences,
A Zyluk, and B Zyluk
November 1994, Annals of neurology,
A Zyluk, and B Zyluk
January 2022, Emergency medicine international,
A Zyluk, and B Zyluk
October 1978, British medical journal,
A Zyluk, and B Zyluk
May 2021, Zhongguo zhen jiu = Chinese acupuncture & moxibustion,
A Zyluk, and B Zyluk
January 2024, Emergency medicine international,
A Zyluk, and B Zyluk
April 1974, Harefuah,
Copied contents to your clipboard!