[Neurological disorders in post-traumatic algodystrophy of the upper extremity].

Sensory disturbances (hypoaesthesia in fingertips and tenderness) and movement disorders (tremor, dystonia, muscle spasms, abnormal postures and inability in initiating of movement) were investigated in 80 patients with post-traumatic reflex sympathetic dystrophy (RSD) of the upper extremity. Sensory disturbances were found in 67 patients (84%): most frequently hypoaesthesia in fingertips--in 49, and tenderness of the dorsal aspect of the hand in 24; in six patients both these signs were present simultaneously. Movement disorders were found less frequently: tremor was observed in 12 patients, spasms of the flexor muscles of the forearm and hand in two, postural dystonia in one, and inability initiating of movement in the other one. Sympathetic interruptions reduced movement disturbances in two patients. Dystonia was resistant to various treatment approaches including botulinum toxin injections. Certain hypothesis explaining pathogenic background of motor and sensory disorders in RSD are discussed. The results of this study show that sensory disturbances are frequently observed in RSD, however, they usually disappear after successful treatment of the condition; movement disorders are less frequent, but much more difficult to control. Neurologists are not frequently faced with the problem of neurological disorders after trauma of the limb. Inclusion of RSD in differential diagnosis may improve recognition of the disorder and result in its faster and proper management.