title: [Reflex sympathetic dystrophy syndrome associated with phenobarbital].
abstract: Reflex sympathetic dystrophy syndrome (RSDS) is clinically characterized by pain and edema of one or more extremities, trophic skin changes and vasomotor instability. Although the pathogenesis is unknown, it could be caused by an abnormal reflex of the sympathetic nervous system. Different studies haven't yet confirmed the classical division in three clinical phases (warm, of vasomotor instability and cold). Barbiturates are the precipitating event in 10-30% of cases. We describe the clinical features of a patient with RSDS associated with phenobarbital who needed corticosteroid treatment. The Technetium diphosphate bone scan (Tc 99m DPD) is very useful because there is an increased radionuclide uptake in the involved areas during the early phases of the disease and precedes in some weeks the radiologic signs. The Magnetic Resonance Imaging (MRI) may be useful because of the early signs it shows. The patient may develop contractures and atrophy of the involved extremities in spite of the indispensable withdrawal of the drug.
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico Universitario, Valencia.
authors.forename: F
authors.initials: F
authors.lastname: Gabriel Botella
authors.forename: M
authors.initials: M
authors.lastname: Labios Gómez
authors.forename: M J
authors.initials: MJ
authors.lastname: Galindo Puerto
authors.forename: M A
authors.initials: MA
authors.lastname: Chapa Villalba
authors.forename: R
authors.initials: R
authors.lastname: Gómez Aldaravi Gutiérrez
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000209:etiology; D001930:Brain Injuries / Q000150:complications; D004164:Diphosphonates; D004829:Epilepsy, Generalized / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010634:Phenobarbital / Q000009:adverse effects* / Q000627:therapeutic use; D011877:Radionuclide Imaging; D012019:Reflex Sympathetic Dystrophy / Q000139:chemically induced* / Q000150:complications; D017556:Technetium Compounds
chemical_list: D000927:Anticonvulsants; D004164:Diphosphonates; D017556:Technetium Compounds; C029045:technetium Tc 99m diphosphonate; D010634:Phenobarbital
vernacular_title: Síndrome de distrofia simpático refleja asociado a fenobarbital.