Reflex sympathetic dystrophy.
Curr Rheumatol Rep
; 4(2): 165-9, 2002 Apr.
Article
in En
| MEDLINE
| ID: mdl-11890882
ABSTRACT
Reflex sympathetic dystrophy (RSD) is composed of five major features pain, swelling, autonomic dysregulation, movement disorders, and atrophy and dystrophy. RSD is caused by an injury to a specific nerve or the C- and A-delta fibers that innervate the involved tissue. It is a progressive illness that spreads with time and may encompass the entire body. There is no psychological disposition to the problem, but all patients are severely depressed because of the constant pain, lack of sleep, and complete disruption of their lifestyle. The continuing pain is usually secondary to the process of central sensitization. The autonomic dysregulation has a major central nervous system component. Atrophy and dystrophy are partly due to loss of nutritive blood supply to the affected tissues. The movement disorder is partly due to deficiency of GABAergic mechanisms; the tremor is an exaggeration of the normal physiologic tremor. Treatment consists of decreasing the afferent pain, maintaining barrage from the underlying defect, and blocking the sympathetic component of the process. New developments include the use of neurotrophic factors to reverse the phenotypic changes that occur in the dorsal horn and the use of pharmacologic agents to block the activity-dependent NMDA channels that appear to be instrumental in maintaining central sensitization.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Reflex Sympathetic Dystrophy
Type of study:
Diagnostic_studies
Limits:
Humans
Language:
En
Journal:
Curr Rheumatol Rep
Journal subject:
REUMATOLOGIA
Year:
2002
Type:
Article
Affiliation country:
United States