Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reflex Sympathetic Dystrophy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed1977

Reflex sympathetic dystrophy.

This paper describes a patient with typical post-traumatic Sudeck's atrophy of the right foot, who subsequently developed an atraumatic, painful osteoporosis of the left foot and right knee. It is suggested that cases of 'migrating osteolysis' and 'transient osteoporosis' of the lower limbs be grouped with classical Sudeck's atrophy as a reflex sympathetic dystrophy; Theories of pathogenesis have been reviewed and a possible theory of causation in atraumatic cases is presented.

Diagnosis, Differential↗
PubMed2002

[Reflex sympathetic dystrophy induced by shunt malfunction: a case report].

A 60-year-old male presented with normal pressure hydrocephalus following subarachnoid hemorrhage and underwent a shunt operation. However, a shunt effective range was so narrow that he repeated a sign of overdrainage and underdrainage of CSF. At the result, reflex sympathetic dystrophy (RSD) as a complication of overdrainage was demonstrated. We could prescribe appropriate shunt flow rate by using siphon control system instead of antisiphon device (ASD) and then avoid shunt malfunction. In addition, medication of Neurotropin for pain control of RSD was so effective. We report a case of RDS as a complication of shunt malfunction.

Cerebrospinal Fluid Shunts↗
PubMed1999

Pain, negative mood, and perceived support in chronic pain patients: a daily diary study of people with reflex sympathetic dystrophy syndrome.

Chronic pain patients show substantial psychological distress, including depressed mood, anxiety, and anger. Nevertheless, the causal role of negative mood in the course of chronic pain conditions remains unclear. This study prospectively investigated the relationship between daily pain, negative mood, and social support in 109 people with reflex sympathetic dystrophy syndrome. Participants completed 28 daily diaries that included questions about pain, mood, and perceived support. Time-lagged within-subject analyses indicated that pain led to increases in depressed, anxious, and angry mood. Depressed mood, but not anxiety or anger, contributed to increases in pain. Perceived support had both main and buffering (interaction) effects on negative mood and a main effect on pain.

Adult↗
PubMed1994

Sympathectomy for reflex sympathetic dystrophy: factors affecting outcome.

This study includes our 12-year experience with chemical sympathetic blocks and surgical sympathectomies for causalgic pain of reflex sympathetic dystrophy (RSD) with emphasis on factors affecting clinical outcome. Medical records of patients undergoing sympathectomies for causalgic pain were analyzed. The patients were classified according to Drucker et al. as stage I, II, or III. Results of chemical and surgical sympathectomies were analyzed using both univariate and multivariate methods. Twenty-one patients had lumbar and seven had cervicodorsal sympathectomies for RSD. The mean duration between initial injury and chemical sympathetic block was 10 months with a mean of 11.4 months to surgical sympathectomy. Ten patients (36%) had overt extremity trauma as the precipitating event. Ten patients (36%) had a lumbar laminectomy, three of whom developed the syndrome bilaterally. There was no operative mortality; however, 25% had transient postoperative sympathetic neuralgia. The early and late (> 6 months) satisfactory outcomes after surgical sympathectomy were 82% and 71%, respectively. Patients with stage II presentations were significantly more likely to have satisfactory early (92%) and late (79%) outcomes than stage III patients, 0% and 0% (p = 0.019). Patients with an excellent response to chemical sympathetic block were more likely to have satisfactory early and late surgical outcomes. The time between injury and chemical block and surgical sympathectomy was significantly shorter in patients who had satisfactory early and late surgical outcomes (p < 0.0001). Multivariate analyses demonstrated that the most important independent factor in determining early and late satisfactory outcomes of sympathectomy was the time between injury and sympathectomy (p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2003

Sympathetic blockade and amitriptyline in the treatment of reflex sympathetic dystrophy.

We prospectively investigated the outcome of a combination therapy of oral amitriptyline and sympathetic ganglion blockade on 10 patients suffering from reflex sympathetic dystrophy of the upper extremity for at least three months. The efficacy of the treatment was evaluated by clinical examination, pain ratings on the visual analogue scale (VAS) and grip strength measurements using the Jamar dynamometer. The results were statistically analysed with Wilcoxon signed-ranks test for comparison of the before and after treatment grip strength measurements and with paired t-test for comparison of the mean of initial and consecutive pain ratings on the VAS. Values of p < 0.01 were considered to be statistically significant. Combination therapy proved beneficial in this particular patient population, which, as far as previously documented studies are concerned, would otherwise respond less favourably to a treatment consisting solely of sympathetic blockade.

Adult↗
PubMed1997

An X-ray absorptiometry study of reflex sympathetic dystrophy syndrome.

X-ray absorptiometry (Lunar DPX) was performed before and after treatment to determine bone mineral content and density, as well as fat-free mass and body fat, in 28 males and 11 females with a mean age of 37 years who met Doury's criteria for reflex sympathetic dystrophy syndrome. Mean disease duration was eight months. Before treatment, as compared to the unaffected limb, bone mineral content was decreased by 8.8%, bone mineral density by 9.6%, and fat-free mass by 6.2%, whereas body fat was increased by 6%. These differences were largest in those patients with the longest disease durations. The severity of bone loss was not correlated with the outcome, the severity of roentgenographic lesions, or whether the patient was evaluated at the warm or cold stage of the disease process. Study parameters were unchanged after three months both in patients who were and were not improved. After nine to 12 months, increases in bone and fat-free mass were seen in those patients whose clinical manifestations had subsided.

Absorptiometry, Photon↗
PubMed1998

Reflex sympathetic dystrophy of the upper extremity--a 5.5-year follow-up. Part II. Social life events, general health and changes in occupation.

The aim of this retrospective long-term follow-up study was to describe the psychosocial aspects, such as social life events (SLE), around the causative event of reflex sympathetic dystrophy (RSD) and the psychological history of 65 patients, 3-9 years after RSD of the upper extremity. General health and long-term changes in occupation were assessed by means of a general health questionnaire (RAND-36) and a structured interview, respectively. SLE, with a life-change unit rate more than 35, was present in 32 patients. A psychological (or psychiatric) history was found in 22 patients. In total, 60% of the patients had a SLE and/or a psychological history. The pain scores of the RAND-36 among RSD patients differed significantly from those of the control group. 17 patients changed occupation after RSD. Nearly 30% of the patients had to stop work for more than one year. The results show a high coincidence between RSD and associated psychosocial disorders and this may play a role in intensifying and prolonging the symptomatology of RSD.

Adolescent↗
PubMed1998

[False positive with Tl-201 in the study of Ewing's sarcoma of the astragalus caused by reflex sympathetic dystrophy].

We describe a 14 year old male, diagnosed of Ewing sarcoma in left astragalus. We performed two 201-Thallium scan for evaluating the response to chemotherapy (before and after the treatment). The scan performed after chemotherapy showed patchy uptake in astragalus, calcaneus and some joints of the foot. The following radiology and scintigraphy diagnosed a reflex sympathetic dystrophy in the left foot due to disuse of the limb. The 201-Thallium overestimated viability of the tumour for this reason. We must discard the presence of this kind of associated pathology in order that they could be cause of false positives.

Adolescent↗
PubMedDate not supplied

Reflex sympathetic dystrophy after a minor electric shock.

A 37-year-old right-handed female sustained a minor electric shock to her right hand while changing a bulb in a Kodak Reliant Intelligent Microfilmer 2000. She noted a progressive onset of parasthesias of her right hand that became associated with throbbing pain at rest, as well as swelling and profound weakness of her hand during the next two months. Plethysmography demonstrated arterial vasoconstriction of her right hand. Her reflex sympathetic dystrophy was successfully treated with cervicothoracic sympathetic blocks.

Adult↗
PubMed1989

The reflex sympathetic dystrophy syndrome associated with traumatic myelopathy: report of 5 cases.

Pain is a frequent problem following recent traumatic spinal cord injury (SCI). Of specific concern in the rehabilitation setting is function-limiting hand pain which prevents optimal participation in therapy and limits independence. A treatable etiology of function-limiting hand pain in SCI is the reflex sympathetic dystrophy syndrome (RSDS). The presentation of RSDS in patients with recent SCI can be easily confused with that of dysesthetic (central origin) or radicular pain. Previous reports of RSDS associated with recent traumatic SCI have not been based on specific clinical criteria outlined in recent literature, and treatment has not been evaluated by objective outcome measures. This report describes 5 cases of RSDS associated with recent traumatic SCI that are identified by specific clinical criteria and are confirmed by a 3 phase bone scan. It is suggested that aggressive early intervention is necessary to obtain optimal functional outcome and minimize length of hospital-based rehabilitation.

Adult↗
PubMedDate not supplied

Normal sympathetic nervous system response in reflex sympathetic dystrophy.

We evaluated sympathetic nervous system activity by sympathetic skin response (SSR) recording and we further investigated sympathetic and opioid outflow indirectly in patients with features of reflex sympathetic dystrophy by measuring concentrations of plasma catecholamines (CAs) and their metabolites and plasma metenkephalin (ME), before and after corticoid treatment. Six patients were studied. Basal SSR latencies, morphologies and amplitudes were normal in five patients. In one woman, latency and amplitude were also normal but the morphology was disturbed. Basal plasma ME, CA and metabolite levels were similar in the affected and non-affected limbs and a significant increase in plasma ME concentrations was observed in both affected and non-affected limbs after two weeks of steroid treatment. Altogether these results point to an adaptive supersensitivity rather than a sympathetic hyperactivity in this syndrome; also, they indicate that the therapeutic effect of steroids adds, to their known anti-inflammatory action, a stimulatory action on the endogenous opioid system.

Adult↗
PubMedDate not supplied

Thermal grill illusion and complex regional pain syndrome type I (reflex sympathetic dystrophy).

BACKGROUND AND OBJECTIVES: In normal humans, placing a hand on a thermal grill containing warm elements separated by cool ones produces a burning sensation. In this case report, responses to a thermal grill in a patient with neuropathic pain were examined. METHODS: The responses of a 31-year-old woman with complex regional pain syndrome type I (reflex sympathetic dystrophy) to a thermal grill were evaluated before and after stellate ganglion block. RESULTS: The patient experienced a burning sensation when the unaffected hand was placed on the grill and could distinguish which element was warm and which was cool. An intolerable burning sensation caused the patient to quickly (within 4 seconds) withdraw the affected hand when it was placed on the grill. Touching cool elements with the affected hand produced an intense burning sensation (cold allodynia), whereas touching warm elements produced a pleasant warm sensation. Stellate ganglion block with phenol, local anesthetic, and steroid resulted in long-lasting absence of cold allodynia. CONCLUSION: The thermal grill may be a useful a tool to help understand the pathophysiology of complex regional pain syndrome type I.

Adult↗
PubMed1995

Intravenous regional sympathetic blockade for pain relief in reflex sympathetic dystrophy: a systematic review and a randomized, double-blind crossover study.

The first aim was a systematic review of intravenous regional sympathetic blocks (IRSBs) in patients with reflex sympathetic dystrophy (RSD). Randomized controlled trials (RCTs) of IRSBs in patients with RSD were identified by MEDLINE search (1966 to May 1993) and by hand search of 30 journals (1950 to May 1993). Authors of eligible trials were asked for information on additional trials and for unpublished data. Seven RCTs of IRSBs in RSD were found. Four used guanethidine; none showed significant analgesic effect in IRSBs to relieve pain due to RSD. Two reports, one using ketanserin and one bretylium, with 17 patients in total, showed some advantage of IRSBs over control. RCT results were not combined because of the variety of different drugs and outcome measures and because of methodological deficiencies in most of the reports. The second aim was a randomized, double-blind, crossover study to assess the effectiveness of IRSBs with guanethidine. Patients fulfilling diagnostic criteria for RSD and who had reported pain relief after an open IRSB with guanethidine received IRSBs with guanethidine high dose, guanethidine low dose, and normal saline. Pain intensity and relief, adverse effects, mood, duration of analgesia, and global scores were recorded. Sixteen patients with diagnosis of RSD were recruited, but only nine entered the double-blind phase. The trial was stopped prematurely because of the severity of the adverse effects. No significant difference was found between guanethidine and placebo on any of the outcome measures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Reflex sympathetic dystrophy, sympathetically maintained pain, and complex regional pain syndrome: diagnoses of inclusion, exclusion, or confusion?

Few painful conditions involving the hand and arm have engendered so much confusion and argument among clinicians and so much suffering in patients as reflex sympathetic dystrophy. Adding to this confusion is the recent proposal by the International Society for the Study of Pain to rename this group of pain conditions "complex regional pain syndrome" (CRPS). In this new terminology, the diagnosis of CRPS relies on clinical assessment alone, and the role of the sympathetic nervous system has been de-emphasized. Sympatholytic interventions are recommended only for the subgroup of patients with sympathetically maintained pain. This article discusses the clinical description of CRPS, reviews the diagnostic tests for this group of conditions, and discusses the lack of reliable data on therapeutic interventions due to poor diagnosis of patients.

Adrenergic alpha-Antagonists↗
PubMed1997

Complex regional pain syndrome (reflex sympathetic dystrophy and causalgia): management with the calcium channel blocker nifedipine and/or the alpha-sympathetic blocker phenoxybenzamine in 59 patients.

Complex Regional Pain Syndrome (CRPS) is the new name for entities formerly known mostly as Reflex Sympathetic Dystrophy and Causalgia. Treatment of CRPS with either the calcium channel blocker nifedipine or the alpha-sympathetic blocker phenoxybenzamine was assessed in 59 patients, 12 with early stages of CRPS, 47 with chronic stage CRPS. In the early stage CRPS patients, 3 of 5 were cured with nifedipine and 8 of 9 (2 of whom had earlier received nifedipine) with phenoxybenzamine, for a cure rate of 92% (11 out of 12). In the chronic stage CRPS patients, 10 of 30 were cured with nifedipine; phenoxybenzamine cured 7 of 17 patients when administered as a first choice and another 2 of 7 patients who received nifedipine earlier, for a total late stage success rate of 40% (19 out of 47). The most common side effects necessitating discontinuing the drug were headaches for nifedipine and orthostatic dizziness, nausea and diarrhoea for phenoxybenzamine. All male patients on phenoxybenzamine experienced impotence, but this did not lead to discontinuing this agent and immediately disappeared after stopping the drug. These results once again stress the importance of early recognition of CRPS, and treatment with either of these drugs could be considered as a first choice for early CRPS, especially because in this series this treatment was not combined with physical therapy making it very cost-effective. In the chronic stage of CRPS, treatment with these drugs was much less successful (40%), even though it was always combined with physical therapy, but it can still be considered, either as a first choice or when other types of treatment have failed.

Adolescent↗
PubMed1990

New thoughts on reflex sympathetic dystrophy syndrome.

Chronic pain caused by a sympathetic nervous system aberration must be considered separately from chronic pain resulting from carcinoma, arthritis, neuropathies and other delineated pathology. Because the pathophysiology of these conditions and their associated pain can be explained, treatment modalities can be planned specific to the affected individual and targeted toward the altered physiology. If the pathophysiology is not clearly defined or understood, as is the case in reflex sympathetic dystrophy and other idiopathic pain conditions, then prescription and remediation become a challenge for the healthcare professional and client. New thoughts on the clinical findings, pathogenesis, diagnosis and prognosis are evolving, with inherent implications for neuroscience nursing.

Humans↗
PubMed1995

Nerve entrapment and reflex sympathetic dystrophy after fractures of the distal radius.

In a series of 542 conservatively-treated fractures of the distal radius 30 patients (5,5%) developed compression neuropathy: of the median nerve (n = 23), of the ulnar nerve (n = 5), and of the radial nerve (n = 2). Three patients required decompression of the carpal tunnel, and one patient's ulnar symptoms were relieved after shortening osteotomy of the ulna. The remaining neuropathies resolved spontaneously over a period of three months. Five patients developed typical reflex sympathetic dystrophy with diffuse pain, loss of hand function, and significant autonomic dysfunction. None of them had specific signs of compression neuropathy anteceding the development of reflex dystrophy. All five had their joints mobilised under regional intravenous block combined with regional perfusion of soluble corticosteroid.

Autonomic Nervous System Diseases↗
PubMed2005

Sympathetic skin responses in reflex sympathetic dystrophy.

This study was performed to determine the utility of sympathetic skin response (SSR) in evaluating the sympathetic function and to follow up the effects of sympathetic blockade in reflex sympathetic dystrophy (RSD). Thirty patients having RSD with upper extremity involvement were randomly divided into two groups. Besides medical therapy and exercise, physical therapy agents were applied to both the groups. In addition to this treatment protocol, stellar ganglion blockade was done by diadynamic current in Group II. The normal sides of the patients were used for the control group. SSRs were measured in all the patients before and after the therapy. The amplitude was found to be increased and the latency was found to be decreased in the affected side in both the groups before the therapy. After the therapy, the amplitude was decreased and latency was increased in both the groups. But, the differences in amplitude (P = 0.001) and latency (P = 0.002) before and after the therapy were significantly higher in Group II. (Before the treatment, SSRs were significantly different between the normal and the affected sides in both the groups. The observed change in SSRs after the treatment was higher in Group II.) It was concluded that, SSR can be a useful and noninvasive method in diagnosing the sympathetic dysfunction in RSD and can be used for evaluating the response to sympathetic blockade and other treatment modalities.

Adult↗