[Complex regional pain syndrome type I: a frequent neurological disease. Reports of two atypical cases].
BACKGROUND
Complex regional pain syndrome type I is an agreed umbrella term used to replace other terms such as sympathetic-reflex dystrophy. This condition is a true neurological disease, which is completely different to the type II variation; both the central and the peripheral nervous systems are involved, the clinical presentation varies from patient to patient and it is diagnosed by means of a series of imprecise agreed criteria that are subject to debate.


METHODS
We report two cases of atypical presentation, both with peculiarities that have not previously appeared in the literature, in which a diagnostic suspicion and proper management favoured the patients' recovery. It is shown how treatment, especially in more severe cases, requires an early, tailored, multidisciplinary approach based on the patient's signs and symptoms as manifestations of the underlying physiopathogenic mechanisms.


CONCLUSIONS
We review currently held knowledge about the pathophysiology of the condition and the therapeutic management that is employed, including the role played by the neurologist, who must work in cooperation with other health care professionals to reach a diagnosis, dissect the physiopathogenic mechanisms at play and plan the treatment of what we hold to be a neurological disease. Future work will need to be aimed at determining the risk factors, explaining the pain mechanisms involved, drawing up a better definition of the different clinical forms and at developing complementary tests, as well as better criteria for diagnosing the condition and enhanced therapeutic algorithms.
Martínez-Salio
A
A
Servicio de Neurología, Hospital Universitario 12 de Octubre, 28045 Madrid, España. amsalio@yahoo.com
Vicente-Fatela
L
L
Acedo-Gutiérrez
M S
MS
Sanz-Ayán
P
P
Almajano
J
J
Urbano-López Nuno
M
M
Rija del Valle
C
C
D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy