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The movement disorder of reflex sympathetic dystrophy
1Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.
Neurology
|January 1, 1990
Summary
Reflex sympathetic dystrophy (RSD) can cause movement abnormalities like dystonia and spasms, sometimes appearing before other symptoms. While Lioresal and sympathetic blockade can help early on, the movement disorder may eventually become independent of sympathetic nerves.
Area of Science:
- Neurology
- Movement Disorders
- Autonomic Nervous System
Background:
- Reflex sympathetic dystrophy (RSD), also known as Complex Regional Pain Syndrome (CRPS), is a chronic pain condition.
- Motor abnormalities are increasingly recognized as a significant component of RSD, impacting patient function and quality of life.
Purpose of the Study:
- To describe the spectrum of motor abnormalities observed in patients with reflex sympathetic dystrophy (RSD).
- To investigate the temporal relationship between motor symptoms and other manifestations of RSD.
- To evaluate the effectiveness of interventions targeting the sympathetic nervous system and pharmacological treatments for motor symptoms in RSD.
Main Methods:
- Retrospective analysis of 43 patients diagnosed with reflex sympathetic dystrophy (RSD).
- Clinical assessment of motor signs and symptoms including dystonia, weakness, spasms, tremor, and altered tone/reflexes.
- Correlation of motor manifestations with sudomotor, vasomotor changes, pain, and response to treatments like Lioresal, sympathetic blockade, and sympathectomy.
Main Results:
- 43 patients with RSD presented with diverse motor abnormalities, including focal dystonia, weakness, spasms, tremor, and increased tone/reflexes.
- Motor symptoms often preceded or occurred concurrently with sudomotor/vasomotor changes and pain, sometimes by weeks or months.
- Lioresal demonstrated efficacy in reducing spasms; early motor manifestations responded to sympathetic blockade or sympathectomy, but the disorder frequently became sympathetic-independent.
Conclusions:
- Motor abnormalities are a common and potentially early feature of reflex sympathetic dystrophy (RSD).
- While sympathetic interventions can alleviate early motor symptoms, the movement disorder in RSD can evolve to become independent of sympathetic innervation.
- Comprehensive management strategies for RSD should address both the autonomic and motor components of the condition.