[Complex regional pain syndrome: the need for multidisciplinary approach].
The title complex regional pain syndrome is being introduced to cover the painful syndromes which formerly were described under the headings reflex sympathetic dystrophy and causalgia. The pain may be sympathetically maintained or sympathetically independent. The incidence of disease with respect to age shows a peak at 50 years, but may be present at any moment of live. The clinical picture of an affected extremity is characterized by autonomic (vasomotor, sudomotor, edema), sensory (allodynia, hyperpathia, hyperalgesia, hyper or hypoesthesia) and motor symptoms. The diagnosis is generally made by clinical examination and with the use of diagnostic aids, such as plain film radiographs, three-phase bone scan, thermography, and diagnostic sympathetic blockade with local anesthetics, guanethidine test, phentolamine test or ischemia test. With regard to the pathophysiology of the disease, although some investigators suggest that these patients suffer from a psychogenic problem, research with animals with experimental neuropathies has revealed several phenomena like that seen in human suggesting the organicity of the disease. The mainstay of treatment, specially in severe cases, is a multidisciplinary approach. The goal is restoration of normal function. Treatment includes adequate pain relief, complete physical therapy program and psychiatric evaluation.
de la Calle-Reviriego
J L
JL
Unidad para el Estudio y Tratamiento del Dolor, Hospital Ramón y Cajal, Madrid, España.
D018663:Adrenergic Agents; D000317:Adrenergic alpha-Antagonists; D000700:Analgesics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis* / Q000534:rehabilitation; D018450:Disease Progression; D005121:Extremities / Q000098:blood supply; D006145:Guanethidine; D006801:Humans; D007511:Ischemia / Q000175:diagnosis; D010147:Pain Measurement; D010348:Patient Care Team; D010646:Phentolamine; D026741:Physical Therapy Modalities; D011613:Psychotherapy / Q000379:methods
D018663:Adrenergic Agents; D000317:Adrenergic alpha-Antagonists; D000700:Analgesics; D010646:Phentolamine; D006145:Guanethidine
Síndrome de dolor regional complejo: la necesidad de un planteamiento multidisciplinar.