title: Reflex sympathetic dystrophy: early treatment and psychological aspects.
abstract: We report the results of two prospective studies of early treatment and psychological aspects in a series of 26 patients with sympathetic reflex dystrophy of the hand in which treatment was started within 3 months after diagnosis. Ismelin blocks is an often used therapy in sympathetic reflex dystrophy but a probable better therapy in the first stage of the dystrophy was also investigated. Thirteen patients were treated with Regional Intravenous Ismelin blocks and 13 other patients were treated with a hydroxyl radical scavenger, dimethylsulfoxide (DMSO). After 9 weeks there was a better result in the group treated with DMSO. This report also describes psychological research in a group of 24 dystrophy patients compared with a control group of 42 patients who underwent elective hand-surgery. Women dystrophy patients were more depressed and emotionally unstable. Eighty percent of all dystrophy patients had a recent life-event while only 20% of the control group members reported such an event. These two features seem to be independent. Early diagnosis in combination with early stress management training and a multidisciplinary treatment tends to be a very good solution.
authors.affiliation: Department of Rehabilitation Medicine, University Hospital Groningen, The Netherlands.
authors.forename: J H
authors.initials: JH
authors.lastname: Geertzen
authors.forename: H
authors.initials: H
authors.lastname: de Bruijn
authors.forename: A T
authors.initials: AT
authors.lastname: de Bruijn-Kofman
authors.forename: J H
authors.initials: JH
authors.lastname: Arendzen
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000765:Anesthesia, Conduction / Q000379:methods; D015984:Causality; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D005260:Female; D006145:Guanethidine / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010348:Patient Care Team; D016059:Range of Motion, Articular; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control; D013997:Time Factors
chemical_list: D004121:Dimethyl Sulfoxide; D006145:Guanethidine