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Reflex sympathetic dystrophy associated with amyotrophic lateral sclerosis
M de Carvalho1, A Nogueira, A Pinto
1Department of Neurology, EMG laboratory-Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisbon, Portugal. mamedemg@mail.telepac.pt
Journal of the Neurological Sciences
|December 14, 1999
Summary
Reflex sympathetic dystrophy (RSD) may worsen amyotrophic lateral sclerosis (ALS) progression. Early detection of RSD in ALS patients is crucial for managing potential accelerated functional decline.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Reflex sympathetic dystrophy (RSD) is a syndrome of severe distal pain and vasomotor changes, often linked to sympathetic nervous system overactivity.
- Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting motor neurons.
- The association between RSD and ALS has been rarely reported.
Observation:
- This study reports on three patients diagnosed with ALS who also developed RSD.
- In one patient, RSD occurred early in the clinical course of ALS.
- The onset of RSD appeared to accelerate the progression of ALS in these patients.
Findings:
- The development of RSD in ALS patients may precipitate a more rapid clinical evolution.
- Abnormal ion channels in new sprouting re-innervating fibers in ALS may increase RSD risk.
- Motor changes are noted in RSD, with potential for motor strength improvement following RSD treatment.
Implications:
- The complex relationship between ALS and RSD warrants further investigation.
- In ALS patients experiencing pain followed by functional decline, a search for RSD is recommended.
- Understanding this association could lead to improved management strategies for ALS patients with comorbid RSD.