Onset and progression of dystonia in complex regional pain syndrome.
نویسندگان
چکیده
Complex regional pain syndrome (CRPS) may lead to movement disorders (MDs) in some patients. Reliable information on the nature, chronology and clinical determinants of MDs in CRPS patients is lacking but could provide better insight in to the underlying pathophysiological mechanism. We retrospectively evaluated the clinical and temporal characteristics of MDs in patients with CRPS. Cox's proportional hazards model was used to evaluate factors influencing the onset of MDs. One-hundred and eighty-five patients suffered CRPS in one or more extremities. MDs occurred in 121 patients, with dystonia (91%) being the most prevalent. Sixty-two percent of these patients displayed dystonia in multiple extremities. Patients with dystonia were on average 11 years younger and more often had CRPS in multiple extremities. The interval between the onset of CRPS and dystonia in the first affected extremity varied from less than 1 week in 26% of the patients to more than 1 year in 27%. The hazard of developing dystonia in subsequent extremities increased with the number of extremities affected by dystonia. We conclude that dystonia in CRPS shows highly variable onset latency and is associated with younger age at onset and increased risk of developing dystonia in other extremities. The delayed onset and progression of dystonia in CRPS may indicate the involvement of a different underlying mechanism, possibly associated with maladaptive neuroplasticity.
منابع مشابه
The Symptom Checklist-90 Revised questionnaire: no psychological profiles in complex regional pain syndrome-dystonia.
Complex regional pain syndrome (CRPS) is a syndrome usually localized in the extremities, mostly occurring after a preceding trauma or operation. Dystonia is present in a minority of CRPS patients, but, when present, leads to severe disability. Various pathological factors have been postulated to present in CRPS-dystonia, such as involvement of the sympathetic system, reorganization of the cent...
متن کاملComplex regional pain syndrome with dystonia in childhood
Background We present 6 children with Complex regional pain syndrome (CRPS) in whom dystonia, including abnormal posture and involuntary movement was a prominent feature. CRPS is known to occur in childhood usually involving severe limb pain, colour and temperature change, with associated loss of function. Dystonia associated with CRPS has never been described in children, although a few cases ...
متن کاملProgression of dystonia in complex regional pain syndrome.
To the Editor: Oaklander's report 1 of a patient with complex regional pain syndrome (CRPS) in addition to a movement disorder is an excellent example of the value of videotape publications. The patient is described as having progressive right lower extremity dystonia and tremor in the contralateral foot. That the movements began abruptly after vein stripping is stated as evidence that neither ...
متن کاملStretch reflex responses in Complex Regional Pain Syndrome-related dystonia are not characterized by hyperreflexia.
OBJECTIVE To evaluate if hyperreflexia (exaggerated reflexes) due to disinhibition is associated with dystonia in Complex Regional Pain Syndrome (CRPS). METHODS Stretch reflexes at the wrist were assessed in healthy controls (n=10) and CRPS-patients with dystonia (n=10). Subjects exerted a wrist flexion torque of 5% of maximum voluntary contraction torque (T(MVC)) to a manipulandum which appl...
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ورودعنوان ژورنال:
- Pain
دوره 130 3 شماره
صفحات -
تاریخ انتشار 2007