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Reflex sympathetic dystrophy in brain-injured patients
Harris Gellman1, Mary Ann E Keenan, Lance Stone
1Adult Brain Injury Service (34-800), Department of Orthopedic Surgery, University of Soutern California, Los Angeles, CAUSA Adult Brain Injury Service (34-800), Department of Nuclear Medicine, Downey, CA 90242 USA Adult Brain Injury Service (34-800), Rancho Los Amigos Medical Center, Downey, CA 90242 USA.
Pain
|December 1, 1992
Summary
Reflex sympathetic dystrophy (RSD) affects 12% of brain injury patients, exclusively in spastic upper extremities. Early diagnosis is crucial to prevent rehabilitation delays and functional loss.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pain Management
Background:
- Brain injury can lead to complex neurological and physical complications.
- Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome, is a debilitating condition that can affect patients with neurological injuries.
- The incidence and characteristics of RSD in the upper extremities of brain-injured patients require further investigation.
Purpose of the Study:
- To determine the incidence of reflex sympathetic dystrophy (RSD) in the upper extremities of patients admitted to a Brain Injury Unit.
- To identify clinical characteristics and risk factors associated with RSD in this patient population.
- To highlight the potential impact of undiagnosed RSD on rehabilitation outcomes.
Main Methods:
- Prospective evaluation of 100 consecutive brain injury patients for signs of RSD.
- Clinical assessment, standard radiographs, and 3-phase radionuclide scintigraphy (bone scan) for suspected RSD cases.
- Comparison of clinical data (Glasgow Coma Scale, Rancho Cognitive Level, associated injuries) between patients with and without RSD.
Main Results:
- An overall incidence of 12% for RSD was observed (12 out of 13 patients with symptoms).
- RSD exclusively occurred in the spastic upper extremity, with a higher incidence in patients with associated upper extremity injuries (75%).
- Patients with RSD had lower initial Glasgow Coma Scores compared to those without RSD.
Conclusions:
- Reflex sympathetic dystrophy (RSD) is a significant concern in brain-injured patients, particularly affecting the spastic upper extremity.
- The presence of associated upper extremity injuries and lower initial Glasgow Coma Scores are potential indicators for RSD development.
- Timely diagnosis and management of RSD are critical to optimize rehabilitation and prevent long-term functional deficits in brain-injured individuals.