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Reflex sympathetic dystrophy. A review.

R J Schwartzman, T L McLellan

    Archives of Neurology
    |May 1, 1987
    PubMed
    Summary

    Reflex sympathetic dystrophy (RSD) causes severe pain and swelling, often triggered by injury but spreading unpredictably. Effective treatment involves blocking sympathetic nerves and physical therapy.

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    Area of Science:

    • Neurology
    • Pain Medicine
    • Rehabilitation

    Background:

    • Reflex sympathetic dystrophy (RSD) is a complex pain syndrome.
    • Characterized by burning pain, hyperesthesia, swelling, and trophic changes.
    • Can be triggered by various factors beyond direct nerve injury.

    Purpose of the Study:

    • To summarize the key features of Reflex Sympathetic Dystrophy.
    • To outline diagnostic methods and therapeutic strategies.
    • To present proposed pathophysiological mechanisms.

    Main Methods:

    • Clinical diagnosis is primary.
    • Diagnostic support includes roentgenography and scintigraphy.
    • Sympathetic blockade aids in confirmation.

    Main Results:

    • RSD presents with distinct symptoms like burning pain and swelling.
    • The condition can spread beyond the initial injury site.
    • Successful therapies focus on sympathetic blockade and physical therapy.

    Conclusions:

    • RSD diagnosis is primarily clinical, supported by imaging and blockade.
    • Therapeutic success hinges on interrupting sympathetic pathways.
    • Pathophysiology theories involve spinal cord circuits, ephaptic transmission, and ectopic pacemakers.

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