Complex Regional Pain Syndrome - Reflex Sympathetic Dystrophy ...

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Sympathetically Maintained Pain (SMP) vs Sympathetically Independent Pain (SIP) • SMP - Describes the aspect of pain that is relieved by blockade of the efferent sympathetic nervous system • SIP - Describes the aspect of pain that is unresponsive to sympathetic blockade • Patients can present with pure SMP, pure SIP or a combination • Pain tends to be SMP early in the disease process and progresses to SIP as disease progresses
Sympathetic Nervous System and Pain • Some neuropathic pain syndromes are characterized by abnormalities in autonomic function – Dystrophy – Alteration in skin temperature and sweating – Disturbances in sympathetic vasomotor and sudomotor function • Prompt pain relief can be achieved by sympatholytic therapy in some patients (SMP) • Activation of the sympathetic nervous system can exacerbate the pain – Mitchell, 1972; Walker and Nulsen, 1948; White, 1954
Page 1 and 2: Complex Regional Pain Syndrome: Pat
Page 5: HEAT HYPERALGESIA IN CRPS • Early
Page 9 and 10: COLD ALLODYNIA IN CRPS • Late phe
Page 11 and 12: Pathophysiologic Mechanisms of CPRS
Page 13 and 14: Sensory Abnormalities in CRPS What
Page 15 and 16: Neuropathic Pain Sympathetically In
Page 17: Complex Regional Pain Syndrome and
Page 21 and 22: Nerve Injury •Cross talk between
Page 23 and 24: Autonomic Dysfunction • Hyperhydr
Page 25 and 26: Neurogenic Inflammation • Extensi
Page 27 and 28: Motor Abnormalities • About 50% o
Page 29 and 30: Other Possible Mechanisms • Persi
Page 31 and 32: Nerve Injury •Cross talk between
Page 33 and 34: Nerve Injury Dorsal Horn Sprouting
Page 35 and 36: Nerve Injury Activation of non neur
Page 37 and 38: Summary • CRPS has an extremely c

Complex Regional Pain Syndrome - Reflex Sympathetic Dystrophy ...

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