Complex regional pain syndrome as a stress response.
A man in his 50's with a prior traumatic brain injury and multiple psychiatric disorders developed acute pain and swelling in his left leg distal to the mid shin. These symptoms arose during an exacerbation of his post-traumatic stress disorder (PTSD). Among his traumatic memories, he reported having witnessed the combat injury and death of a friend who had lost his left leg distal to the mid shin. A diagnosis of conversion disorder was technically excluded because the findings met criteria for Complex Regional Pain Syndrome (CRPS) type I. Based on recent research into the neurobiology of CRPS, PTSD and conversion disorder, we propose a supraspinal mechanism which could explain how emotional stress can produce both symptoms and signs.
Grande
Lucinda A
LA
Department of Neurology, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA.
Loeser
John D
JD
Ozuna
Judy
J
Ashleigh
Alexandra
A
Samii
Ali
A
D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000928:Antidepressive Agents; D014150:Antipsychotic Agents