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Pain in primary erythromelalgia--a neuropathic component?
Kristin Ørstavik1, Cato Mørk, Knut Kvernebo
1Laboratory of Clinical Neurophysiology, Department of Neurology, Rikshospitalet University Hospital, 0027 Oslo, Norway Department of Dermatology, Rikshospitalet University Hospital, 0027 Oslo, Norway Department of Cardiothoracic Surgery, Ullevaal University Hospital, 0447 Oslo, Norway.
Pain
|August 4, 2004
Summary
Erythromelalgia patients show impaired small nerve fiber function, suggesting a neuropathic pain component. This study investigated afferent nerve fibers in erythromelalgia, revealing sensory deficits and pain abnormalities.
Area of Science:
- Neurology
- Pain Medicine
- Dermatology
Background:
- Erythromelalgia is characterized by red, hot, painful extremities, traditionally linked to circulatory issues.
- Recent findings suggest a neuropathic component involving efferent small nerve fibers.
- The study aimed to investigate potential involvement of afferent nerve fibers due to symptom similarity with neuropathic pain.
Purpose of the Study:
- To investigate the affection of afferent nerve fibers in patients with primary erythromelalgia.
- To compare sensory thresholds in erythromelalgia patients with healthy controls.
- To explore the neuropathic component of pain in erythromelalgia.
Main Methods:
- Neurological testing, neurography, and quantitative sensory testing were performed on 25 primary erythromelalgia patients.
- Thermal and pain detection thresholds were assessed at the feet and compared to 29 healthy controls.
- Presence of brush-evoked allodynia and punctate hyperalgesia was evaluated.
Main Results:
- Erythromelalgia patients exhibited significantly higher heat and cold detection thresholds compared to controls, indicating impaired small fiber function.
- Seven patients reported brush-evoked allodynia, and fourteen had punctate hyperalgesia in symptomatic foot areas.
- Patients clustered into groups with reduced small fiber input or normal thermal thresholds with hyperalgesia.
Conclusions:
- The findings suggest impaired afferent small nerve fiber function in erythromelalgia patients.
- The symptoms and sensory alterations indicate a potential neuropathic component to erythromelalgia pain.
- Further research into small fiber neuropathy in erythromelalgia is warranted.
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