RESUMEN
Complex regional pain syndrome (CRPS) is a frequent complication appearing as pain of unexplained pathogenesis. Its association with Lyme borreliosis (LB) is fairly rare. In the presented clinical case, clinical features as well as the findings of radiological, radionuclide, neurophysiological and serological investigations pointed to an association between the two conditions. The patient fulfilled the criteria for both diagnoses, i.e. CRPS and LB. The subsequent antibiotic therapy resulted in a complete remission of both clinical entities.
Asunto(s)
Síndromes de Dolor Regional Complejo/etiología , Enfermedad de Lyme/complicaciones , Humanos , Persona de Mediana Edad , Piel/inervación , Sistema Nervioso Simpático/fisiopatologíaAsunto(s)
Carbamazepina/efectos adversos , Enfermedades del Sistema Nervioso Central/patología , Hipersensibilidad a las Drogas/tratamiento farmacológico , Epilepsia/tratamiento farmacológico , Vasculitis/patología , Carbamazepina/uso terapéutico , Enfermedades del Sistema Nervioso Central/complicaciones , Hipersensibilidad a las Drogas/complicaciones , Epilepsia/complicaciones , Femenino , Humanos , Persona de Mediana Edad , Síndrome , Vasculitis/complicacionesRESUMEN
30 patients with moderate diabetic polyneuropathy (Stage 2 according to Dyck) were evaluated for autonomic symptoms, sympathetic skin response (SSR) and Valsalva index. Their SSR were compared to a control group of 30 healthy normal subjects. Neuropathy was confirmed by history, clinical examination and nerve conduction measurements. Although our patients had only moderate polyneuropathy autonomic dysfunction was frequent. Two thirds reported autonomic symptoms. Impotence was present in 60% of males. SSR amplitudes were significantly lower in diabetics (changed in 53%, absent in 20%) than in the controls. SSR abnormality correlated to some clinical and electroneurographic signs of neuropathy, suggesting similar affection of sympathetic and somatic fibres. Valsalva index was abnormal in 37% of patients showing no correlation to clinical, electroneurographic or SSR changes.