Reflex Sympathetic Dystrophy Syndrome
Reflex Sympathetic Dystrophy Syndrome Causes
Currently, the cause of reflex sympathetic dystrophy syndrome is not known. However, certain precipitating factors have been identified, including illness, surgery, and injury. On the other hand, there are a number of documented cases wherein patients have no prior injury to the original site.
Reflex Sympathetic Dystrophy Syndrome Definition
Reflex sympathetic dystrophy syndrome is a form of a chronic neurological condition commonly known as Complex Regional Pain Syndrome (CRPS). Reflex sympathetic dystrophy is Type I of CRPS and does not demonstrate any distinct nerve lesions. (Conversely, Causalgia or type II CRPS presents with evident nerve damage.)
Reflex Sympathetic Dystrophy Syndrome Diagnosis
Currently, there is no specific diagnostic test for CRPS. Reflex sympathetic dystrophy syndrome can be diagnosed primarily though observation of the patient's symptoms. However, certain tests such as x-rays, sweat testing, thermography, sympathetic blocks, and electrodiagnostics can be conducted to confirm the diagnosis.
Reflex Sympathetic Dystrophy Syndrome Symptoms and Signs
CRPS symptoms often manifest in an area near the site of an injury, whether minor or major, and ultimately spreading beyond the original area. In reflex sympathetic dystrophy syndrome, the most common symptom is severe burning pain at the site of the injury. Patients may also suffer from muscle spasm, restricted mobility, joint stiffness, pathological changes in bone and skin, and constriction of the blood vessels that affect skin color and temperature. Other known symptoms include excessive sweating, tissue swelling, and an oversensitivity to touch. If diagnosis and treatment is delayed, inflicted patients may suffer from extreme physical and psychological problems.
Reflex Sympathetic Dystrophy Syndrome Treatment
Treatment for CRPS in general consists of different medications integrated with physical and/or occupational therapy. Drugs used in treating the disorder include antidepressants, anti-inflammatories, GABA analogs, and alpha or beta adrenergic blocking compounds. Local anesthetics are initially injected and repeated when necessary. Surgical intervention may include the implantation of spinal cord stimulators in the epidural space or directly above the nerves outside the CNS. In some cases, drug pumps are implanted to directly deliver pain medication to the cerebrospinal fluid. As a last resort for severe cases (particularly in patients with imminent tissue loss, recurrent infection, edema, or ischemic necrosis), surgical, chemical, or radiofrequency sympathectomy can be used. Perhaps the most important component of treatment is physical therapy. Inactivity often aggravates the disease and intensifies the pain cycle. Therapy should be focused on helping the patient slowly transition to physical activity and movement, gradually stimulating the affected areas.