COMPLEX REGIONAL PAIN SYNDROME REFLEX SYMPATHETIC DYSTROPHY SYNDROME DIAGNOSIS AND THERAPY- A REVIEW OF 824 PATIENTS (ABSTRACT SUMMARY***) Hooshang Hooshmand, M.D. and Masood Hashmi, M.D. Neurological Associates Pain Management Center 1255 37th Street, Suite B Vero FL 32960 *** This abstract is summarized from the review article Complex Regional Pain Syndrome- Reflex Sympathetic Dystrophy Syndrome: Diagnosis and Therapy- A Review of 824 Patients ( Pain Digest- 1999; 9:1-24) INTRODUCTION This is a study of 824 Complex regional pain syndrome (CRPS) patients treated between January 1991 thru January 1996. The diagnostic and therapeutic approaches are compared with medical literature. At least two follow up visits was required to enable a patient to be included in the study. Problems of terminology, over - and under -diagnosis are discussed. For over a century, CRPS has been recognized as a syndrome. This syndrome is a complex form of neuropathic pain associated with hyperpathia; neurovascular instability, neuroinflammation, and limbic system dysfunction. It is triggered by stimulation of neurovascular thermoreceptor c- fibers sensitized to norepinephrine. This afferent sensory impulse leads to CRPS . The syndrome involves extremities, head, back, shoulder, breast, as well as viscera. The neurovascular dysfunction of CRPS separates this condition from the somatic (unrelated to the sympathetic) system pain syndromes. The standard somatic pain is a circumscribed, focalized pain sensation usually not accompanied by neurovascular dysfunction. It does not generate an inflammatory response. In somatic pain, the involved larger myelinated fibres (somatosensory nerve fibres) can be easily detected and studied by nerve conduction studies. This is in contrast to
COMPLEX REGIONAL PAIN SYNDROME REFLEX SYMPATHETIC DYSTROPHY SYNDROME DIAGNOSIS AND THERAPY- A REVIEW OF 824 PATIENTS (ABSTRACT SUMMARY***) Hooshang Hooshmand, M.D. and Masood Hashmi, M.D. Neurological Associates Pain Management Center 1255 37th Street, Suite B Vero FL 32960 *** This abstract is summarized from the review article Complex Regional Pain Syndrome- Reflex Sympathetic Dystrophy Syndrome: Diagnosis and Therapy- A Review of 824 Patients ( Pain Digest- 1999; 9:1-24) INTRODUCTION This is a study of 824 Complex regional pain syndrome (CRPS) patients treated between January 1991 thru January 1996. The diagnostic and therapeutic approaches are compared with medical literature. At least two follow up visits was required to enable a patient to be included in the study. Problems of terminology, over - and under -diagnosis are discussed. For over a century, CRPS has been recognized as a syndrome. This syndrome is a complex form of neuropathic pain associated with hyperpathia; neurovascular instability, neuroinflammation, and limbic system dysfunction. It is triggered by stimulation of neurovascular thermoreceptor c- fibers sensitized to norepinephrine. This afferent sensory impulse leads to CRPS . The syndrome involves extremities, head, back, shoulder, breast, as well as viscera. The neurovascular dysfunction of CRPS separates this condition from the somatic (unrelated to the sympathetic) system pain syndromes. The standard somatic pain is a circumscribed, focalized pain sensation usually not accompanied by neurovascular dysfunction. It does not generate an inflammatory response. In somatic pain, the involved larger myelinated fibres (somatosensory nerve fibres) can be easily detected and studied by nerve conduction studies. This is in contrast to
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