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Results for “Reflex Sympathetic Dystrophy”

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At least 199 records · Page 11Linked to original sources

PubMed1992

Reflex sympathetic dystrophy of the stump in below-knee amputees.

OBJECTIVE: To document the occurrence of reflex sympathetic dystrophy of the stump in two patients with below-knee amputation. DESIGN: A retrospective survey emphasising two clinical case reports. SETTING: Department of orthopaedic rehabilitation at a teaching rehabilitation hospital. PATIENTS: Lower limb amputees (n = 164) were accepted for prosthetic rehabilitation. Twenty-one amputees were regarded as rehabilitation failures; in two below-knee amputees intractable pain was the major problem. RESULTS: Clinical manifestations, radiological, and scintigraphic findings in the two amputees with intractable pain met the criteria for diagnosis of reflex sympathetic dystrophy. CONCLUSIONS: Reflex sympathetic dystrophy of the stump should be suspected in below-knee amputees whenever severe pain persists over a period of 3 to 4 months following amputation.

Amputation Stumps↗

PubMed2001

[Professional outcome of reflex sympathetic dystrophy].

OBJECTIVE: In spite of physical medicine and rehabilitation care, post-traumatic reflex sympathetic dystrophy can be at the origin of articular deficiency, which decrease the capacity to return to work. The aim of this study is to know the professional future of patients who present post-traumatic reflex sympathetic dystrophy. MATERIAL AND METHOD: Eighteen months prospective study, carried out from patients in age to work, hospitalized in physical medicine and rehabilitation unit for ostéo-articular traumatism complicated by reflex sympathetic dystrophy. Description of the population and comorbidity factors preventing professional resumption. Determination of the duration of medical certificate and the modalities of professional resumption. RESULTS: From 16 patients in age to work, only 12 were able to resume a full time profession with an average period of 10.5 months +/- 5. The importance of the, the distale articular location of reflex sympathetic dystrophy (wrist - hand, ankle - foot), the association with a comorbidity such as chronic alcoholism represent pejorative factors of working resumption. Organizations of workstation are often necessary in six cases over eight, if the job is not sedentary. In the most complicated cases, inaptitudes in the work are pronounced with demand of professional reclassifying. CONCLUSION: Post-traumatic reflex sympathetic dystrophy represents a real challenge for the rehabilitation team, to minimize deficiencies and to help the patient to become again a worker.

Activities of Daily Living↗

PubMed2003

[Reflex sympathetic dystrophy involving the ankle in pregnancy: characteristics and therapeutic management].

We report the case of a multigravida presenting in the first trimester of pregnancy with reflex sympathetic dystrophy involving both ankles. Preferential location of reflex sympathetic dystrophy in pregnancy is classically the hip (9 times out of 10). Symptoms develop mostly with primipara in the third trimester of pregnancy or in post-partum. Fracture is the major risk of reflex sympathetic dystrophy. Peculiarities of reflex sympathetic dystrophy's treatment in the course of pregnancy are evoked. The end of the pregnancy can be shortened with the aim of stabilizing disease even to activate its healing. Pathophysiologic mechanisms of reflex sympathetic dystrophy in pregnancy seem multiple and complex. Our observation, by its atypical characteristics, recalls it.

Adult↗

PubMed1989

Reflex sympathetic dystrophy associated with squamous cell carcinoma of the lung.

Reflex sympathetic dystrophy was the presenting feature in an otherwise occult case of non-metastatic squamous cell carcinoma of the lung which improved on surgical removal of the primary tumour. Reflex sympathetic dystrophy, therefore, should be considered an occasional manifestation of a paraneoplastic syndrome warranting a thorough search for underlying malignancy.

Aged↗

PubMed2001

Clinical aspects of multifocal or generalized tonic dystonia in reflex sympathetic dystrophy.

The authors describe 10 patients with reflex sympathetic dystrophy that progressed to a multifocal or generalized tonic dystonia. The neuropsychologic profile was similar to that of other patients with chronic pain, irrespective of its cause. The distribution pattern of dystonia, the stretch reflex abnormalities, and the worsening of dystonia after tactile and auditory stimuli suggest impairment of interneuronal circuits at the brainstem or spinal level. Antibody titers for glutamic acid decarboxylase, tetanus, and Sjögren antigens were all normal.

Adolescent↗

PubMed1999

Complex Regional Pain Syndrome-Reflex Sympathetic Dystrophy.

Complex regional pain syndrome-reflex sympathetic dystrophy (CRPS/RSD) is a complex pain-dysfunction syndrome of unknown cause that typically affects a single extremity. Changes are usually more marked peripherally. There are no generally accepted clinical diagnostic criteria or laboratory studies for CRPS/RSD; our current state of knowledge allows the diagnosis to be made only on clinical grounds. Clinical suspicion should be raised if pain and disability are greater than would usually be expected as a result of the original incident, if recovery is slower than expected, and if autonomic changes are prominent in the affected extremity. The pain associated with the condition may be sympathetically maintained, sympathetically independent, or both. No evidence-based treatment regimens for CRPS/RSD are available. Treatment of the individual patient is empiric and uses symptomatic techniques that seem logical or that have been proven to be effective in other conditions. The sympathetic nervous system makes an unknown contribution to CRPS/RSD, but it is not known whether this is a cause or an effect of the pain. Psychological and psychiatric changes are probably secondary rather than etiologic. Treatment should be immediate, aggressive, and directed toward restoration of full function of the extremity. Various analgesic techniques may be necessary to permit the patient to comply with the rehabilitation program. This program is best carried out in a comprehensive interdisciplinary setting, with a primary emphasis on functional restoration.

Journal Article↗

PubMed1996

"Cold" reflex sympathetic dystrophy in an adult.

The classical presentation of acute reflex sympathetic dystrophy (RSD) or triple-phase bone scintigraphy usually consists of increased periarticular uptake in each phase. The authors present a rare case of acute adult RSD characterized by bone hypofixation of Tc-99m MDP. Reflex sympathetic dystrophy in adults and children is reviewed.

Adult↗

PubMed1983

Reflex sympathetic dystrophy (causalgia) treatment with guanethidine.

Three cases of reflex sympathetic dystrophy (causalgia) were associated with cervical spondylosis. Two of them were related to sudden cervical trauma. Patients showed burning pain, hyperalgesia in a segmental distribution, and edema of the arms, hands, and fingers bilaterally. Oral administration of guanethidine sulfate was effective in all cases. Our results support the hypothesis that hypersensitivity to norepinephrine plays a role in reflex sympathetic dystrophy.

Aged↗

PubMed1993

Segmental reflex sympathetic dystrophy: clinical and scintigraphic criteria.

Clinical and scintigraphic criteria are proposed for the diagnosis of segmental reflex sympathetic dystrophy. Eight patients met previously described clinical criteria for reflex sympathetic dystrophy with involvement limited to only a portion of the hand. The delayed phase of the three-phase radionuclide bone scan was found to be highly sensitive (100%) for this small group of patients. Consecutive bone scans (n = 127) performed during a 6-month period for a variety of upper extremity problems were reviewed, and a segmentally diffuse pattern of tracer uptake was found to be highly specific (98%) for segmental reflex sympathetic dystrophy. Recognition and documentation of a more localized form of reflex sympathetic dystrophy will allow earlier recognition and treatment, which is an important factor in a successful outcome for managing pain dysfunction disorders.

Adult↗

PubMedDate not supplied

Sensitized nociceptors in reflex sympathetic dystrophies.

Painful neurogenic syndromes commonly diagnosed as reflex sympathetic dystrophy (RSD) may not be the consequence of sympathetic dysfunction. Recent experimental data on the mechanism of hyperalgesia indicate that the primary pathophysiological mechanism of RSD may be sensitization of either peripheral nociceptors, or central neurons, or both. The sympathetic system might be involved in maintaining this condition, but this is not always the case. This presentation is an attempt to interpret clinical neuropathic syndromes on the basis of new scientific knowledge.

Humans↗

PubMed1991

Abnormalities of cutaneous blood flow regulation in patients with reflex sympathetic dystrophy as measured by laser Doppler fluxmetry.

The response of cutaneous blood flow to autonomic stimuli was evaluated in eight patients with clinically staged reflex sympathetic dystrophy and eight healthy control subjects. Blood flow was measured in the affected and contralateral extremities by laser Doppler fluxmetry. Five autonomic stimuli were applied to the contralateral extremity during blood flow measurement in the ipsilateral affected extremity. Affected limbs of patients with reflex sympathetic dystrophy were found to have statistically significantly increased blood flow during the Valsalva maneuver and cold pressor test, while blood flow decreased in normal controls. No significant differences were found in limb temperature or baseline blood flow between patients and controls. Reflex sympathetic dystrophy stage did not affect response to the procedures. Control subjects demonstrated a rhythmic cycling of cutaneous blood flow that was absent in patients with reflex sympathetic dystrophy. These results support a central abnormality of the sympathetic nervous system in reflex sympathetic dystrophy.

Adult↗

PubMedDate not supplied

Reflex sympathetic dystrophy associated with low lumbar disc herniation.

Reflex sympathetic dystrophy can be associated with lumbar disc herniations. Both central and peripheral neuroanatomic pathways can be implicated in the development of this syndrome. Clinical findings of vasomotor instability in the leg supported by plain roentgenograms showing osteopenia, bone scan showing increased uptake, and a favorable response with sympathetic blocks suggest the diagnosis. Symptoms should be relieved with appropriate nerve root decompression but may require, in addition, a therapeutic lumbar sympathetic blockade.

Aged↗

PubMed1992

Intravenous regional bretylium and lidocaine for treatment of reflex sympathetic dystrophy: a randomized, double-blind study.

Patients with reflex sympathetic dystrophy, who received transient pain relief from stellate ganglion blocks or lumbar sympathetic blocks and had abnormal isolated cold stress tests, were enrolled in a study to determine the efficacy of intravenous regional bretylium. Each patient received two control treatments (0.5% lidocaine) and two treatments with 0.5% lidocaine and bretylium 1.5 mg/kg in a randomized, double-blind fashion. A standard intravenous regional technique was used with a 300-mm Hg tourniquet pressure for 20 min. Patients kept a daily record of pain relief (0 = no relief, 100% = complete relief). A decrease in pain of more than 30% was considered clinically significant. Therefore, once the patient's pain relief was less than 30%, the next intravenous regional treatment was performed. Bretylium and lidocaine provided more than 30% pain relief for a mean of 20.0 (+/- 17.5) days, whereas lidocaine alone provided relief for only 2.7 (+/- 3.7) days (Mann-Whitney U-test, P less than 0.001). A mean temperature increase in the treated limb of +2.64 +/- 3.41 degrees C above the baseline temperature was noted after bretylium administration, whereas after control treatments the change was -0.086 +/- 1.30 degrees C (Mann-Whitney U-test, P less than 0.02). We conclude that the combination of bretylium and lidocaine is significantly more effective than lidocaine alone when an intravenous block is used to treat reflex sympathetic dystrophy.

Autonomic Nerve Block↗

PubMedDate not supplied

Combined anesthetic and surgical treatment of reflex sympathetic dystrophy following a healed crush injury of the foot.

Reflex sympathetic dystrophy is an often overlooked diagnostic cause of posttraumatic pain. After wound healing, persistent pain frequently is treated with continued analgesic administration, physical therapy, acupuncture, nerve blocks, psychotherapy and sometimes even ignored in hopes that either the pain or the patient will "go away." The authors relate successful evaluation and treatment of reflex sympathetic dystrophy in the case of a young man with disabling pain following a healed crush injury to his foot.

Adult↗

PubMed1989

Transcutaneous electrical nerve stimulation and spinal cord stimulation for pain relief in reflex sympathetic dystrophy.

35 patients with the diagnosis of reflex sympathetic dystrophy in a late stage have been treated with transcutaneous electrical nerve stimulation (TENS). 6 out of the 35 were also submitted to spinal cord stimulation (SCS). The follow-up was from 10 to 36 months. The results obtained were TENS group: 25% excellent, 45% good, 10% fair, 20% poor; in the SCS group: 16.6% excellent; 66.6% good and 16.6% fair. In the long run these results are better than those obtained with sympathetic blocks and sympathectomy. TENS and SCS have no effect on osteoporosis or ankylosis.

Adult↗

PubMedDate not supplied

Reflex sympathetic dystrophy syndrome in children.

We report 3 children with reflex sympathetic dystrophy syndrome, review the literature, and discuss current concepts of diagnosis and management. In this disorder, pain, tenderness, swelling, vasomotor instability, and dystrophic skin changes frequently develop after minor injury. The clinical diagnosis is supported by osteopenia detected on radiographs and either increased or decreased radionuclide uptake on bone scan of the affected extremity. Treatment with a graduated program of physical therapy and transcutaneous electrical nerve stimulation is beneficial in almost all patients. In contrast to adults, the prognosis of childhood reflex sympathetic dystrophy syndrome is favorable; most children recover completely after one episode.

Adolescent↗

PubMed1977

Reflex sympathetic dystrophy in children.

Two pediatric patients had reflex sympathetic dystrophy, which has been well described in adults but is rarely recognized in children. The syndrome consists of continuous pain, hyperesthesia, and autonomic symptoms occurring in an extremity, usually following trauma. The various types of presentation, differential diagnosis, and modes of therapy are discussed.

Adolescent↗

PubMed1992

[Persistent pain following discal sciatica: reflex sympathetic dystrophy, an unusual complication to be examined. Apropos of 4 cases].

Four patients who developed unilateral reflex sympathetic dystrophy of a lower limb associated with a bout of sciatica due to lumbar disc herniation are reported herein. In two cases, reflex sympathetic dystrophy developed after resolution of the sciatica, whereas the two conditions were concomitant in the two other patients. In all four patients, the diagnosis of reflex sympathetic dystrophy was missed. Surgery to release the root was considered in two cases. The reflex sympathetic dystrophy resolved within 1 to 3 months in every case. In view of the incidences of these two conditions, their concomitant occurrence seems rare. To avoid unwarranted therapeutic procedures, reflex sympathetic dystrophy should be considered in patients with chronic painful manifestations accompanying root involvement.

Adult↗