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Laboratory findings in reflex sympathetic dystrophy: a preliminary report
P A Low1, P C Amadio, P R Wilson
1Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905.
The Clinical Journal of Pain
|September 1, 1994
Summary
This study found that combining sudomotor and vasomotor tests reveals autonomic dysfunction in all reflex sympathetic dystrophy patients. These autonomic index quantifications improve clinical evaluation for this condition.
Area of Science:
- Autonomic Nervous System Research
- Clinical Neuroscience
- Medical Diagnostics
Background:
- Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome, is a challenging condition to diagnose.
- Assessing autonomic function is crucial for understanding and managing RSD.
Purpose of the Study:
- To compare sudomotor (sweat) and vasomotor (blood flow) indices in patients diagnosed with clinical reflex sympathetic dystrophy.
- To determine the utility of quantifying autonomic dysfunction in RSD patients.
Main Methods:
- Vasomotor tone assessed via skin blood flow (laser Doppler) and skin temperature (infrared thermometry).
- Sudomotor function evaluated using the quantitative sudomotor axon reflex test (QSART) for sweat output.
- Data collected from 12 extremity RSD patients and compared to 223 healthy controls.
Main Results:
- Significant asymmetry in resting sweat output (67%), QSART responses (75%), and vasomotor changes (80%) observed in RSD patients.
- When both sudomotor and vasomotor abnormalities were considered together, all patients exhibited dysfunction.
- Combined autonomic index assessment proved highly sensitive for detecting abnormalities in RSD.
Conclusions:
- Laboratory-based quantification of autonomic indices provides valuable objective data.
- These objective measures significantly enhance the clinical assessment and diagnostic confidence for patients with reflex sympathetic dystrophy.