Complex Regional Pain Syndrome - Reflex Sympathetic Dystrophy ...

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Autonomic Dysfunction What we know • There is a peripheral and central autonomic reorganization in CRPS What we don’t know • What is the mechanism of the pain that results from the autonomic dysfunction (response to inflammation versus nerve injury)
Neurogenic Inflammation • Extensive plasma extravasation in patients with acute CRPS • Increased joint effusions, protein and synovial hypervascularity • Axon reflex vasodilitation increased after C fiber stimulation • Increased systemic CGRP in the acute phase • Increased tissue levels of TNFα and IL-6 • Increased production of nitric oxide from peripheral monocytes Oyen et al, 1993; Graif et al, 1998; Renier et al, 1983; Birklein et al, 2001; Huygen et al, 2002; Hartrick et al, 2002
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 and 18: Complex Regional Pain Syndrome and
Page 19 and 20: Sympathetic Nervous System and Pain
Page 21 and 22: Nerve Injury •Cross talk between
Page 23: Autonomic Dysfunction • Hyperhydr
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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