Traumatic neuralgias: complex regional pain syndromes (reflex sympathetic dystrophy and causalgia): clinical characteristics, pathophysiological mechanisms and therapy. 1998

G Wasner, and M M Backonja, and R Baron
Klinik für Neurologie, Christian-Albrechts-Universität Kiel, Germany.

Complex regional pain syndromes (CPRS) may develop as a disproportionate consequence of a trauma affecting the limbs without (CRPS I, reflex sympathetic dystrophy) or with (CRPS II, causalgia) obvious nerve lesions. The clinical picture of CRPS consists of asymmetrical distal extremity pain, swelling, and autonomic (sympathetic) and motor symptoms. Changes in the peripheral and central somatosensory, autonomic and motor processing, and a pathologic interaction of sympathetic and afferent systems are discussed as underlying pathophysiologic mechanisms. Therapeutic strategies include pharmacologic pain relief, sympatholytic interventions, and rehabilitation.

UI MeSH Term Description Entries
D010525 Peripheral Nerves The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. Endoneurium,Epineurium,Perineurium,Endoneuriums,Epineuriums,Nerve, Peripheral,Nerves, Peripheral,Perineuriums,Peripheral Nerve
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
D002422 Causalgia A complex regional pain syndrome characterized by burning pain and marked sensitivity to touch (HYPERESTHESIA) in the distribution of an injured peripheral nerve. Autonomic dysfunction in the form of sudomotor (i.e., sympathetic innervation to sweat glands), vasomotor, and trophic skin changes may also occur. (Adams et al., Principles of Neurology, 6th ed, p1359) Complex Regional Pain Syndrome Type II,CRPS Type II,Causalgia Syndrome,Deafferentation Pain,Type II Complex Regional Pain Syndrome,Causalgia Syndromes,Pain, Deafferentation,Syndrome, Causalgia,Syndromes, Causalgia
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000700 Analgesics Compounds capable of relieving pain without the loss of CONSCIOUSNESS. Analgesic,Anodynes,Antinociceptive Agents,Analgesic Agents,Analgesic Drugs,Agents, Analgesic,Agents, Antinociceptive,Drugs, Analgesic
D013564 Sympathetic Nervous System The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. Nervous System, Sympathetic,Nervous Systems, Sympathetic,Sympathetic Nervous Systems,System, Sympathetic Nervous,Systems, Sympathetic Nervous
D020918 Complex Regional Pain Syndromes Conditions characterized by pain involving an extremity or other body region, HYPERESTHESIA, and localized autonomic dysfunction following injury to soft tissue or nerve. The pain is usually associated with ERYTHEMA; SKIN TEMPERATURE changes, abnormal sudomotor activity (i.e., changes in sweating due to altered sympathetic innervation) or edema. The degree of pain and other manifestations is out of proportion to that expected from the inciting event. Two subtypes of this condition have been described: type I; (REFLEX SYMPATHETIC DYSTROPHY) and type II; (CAUSALGIA). (From Pain 1995 Oct;63(1):127-33) Acute Regional Pain Syndrome,Chronic Regional Pain Syndrome,Complex Regional Pain Syndrome,Pain Syndromes, Regional Complex,CRPS (Complex Regional Pain Syndromes)

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