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Reflex Sympathetic Dystrophy
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2010
Year
Neuromusculoskeletal DisorderAutonomic SystemReflex Sympathetic DystrophySympathetic Nervous SystemPhysiologyNeuropathologyMedicinePeripheral Nervous System
Reflex sympathetic dystrophy is a syndrome of burning pain, hyperesthesia, swelling, hyperhidrosis, and trophic skin and bone changes that can be triggered by various factors beyond nerve injury and may spread beyond dermatomal boundaries. The study investigates therapies that block sympathetic innervation to the affected limb alongside physical therapy. Diagnosis relies on clinical assessment, with imaging and sympathetic blockade aiding confirmation, while treatment involves sympathetic blockade of the affected limb.
• Reflex sympathetic dystrophy is a syndrome of burning pain, hyperesthesia, swelling, hyperhidrosis, and trophic changes in the skin and bone of the affected extremity. It is precipitated by a wide variety of factors in addition to nerve injury. It occurs outside of dermatomal distributions and can spread to involve other extremities without new injury. The diagnosis is primarily clinical, but roentgenography, scintigraphy, and sympathetic blockade can help to confirm the diagnosis. The most successful therapies are directed toward blocking the sympathetic innervation to the affected extremity, in conjunction with physical therapy. The theories proposed to explain the pathophysiology of reflex sympathetic dystrophy include "reverberating circuits" in the spinal cord that are triggered by intense pain, ephaptic transmission between sympathetic efferents and sensory afferents, and the presence of ectopic pacemakers in an injured nerve.