Revista de neurologia · 2007
[Complex regional pain syndrome type I: a frequent neurological disease. Reports of two atypical cases].
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Martínez-Salio A, Vicente-Fatela L, Acedo-Gutiérrez M S, Sanz-Ayán P, Almajano J, Urbano-López Nuno M, Rija del Valle C
Аннотация
INTRODUCTION: Complex regional pain syndrome type I is an agreed umbrella term used to replace other terms such as sympathetic-reflex dystrophy. This condition is a true neurological disease, which is completely different to the type II variation; both the central and the peripheral nervous systems are involved, the clinical presentation varies from patient to patient and it is diagnosed by means of a series of imprecise agreed criteria that are subject to debate.
CASE REPORTS: We report two cases of atypical presentation, both with peculiarities that have not previously appeared in the literature, in which a diagnostic suspicion and proper management favoured the patients' recovery. It is shown how treatment, especially in more severe cases, requires an early, tailored, multidisciplinary approach based on the patient's signs and symptoms as manifestations of the underlying physiopathogenic mechanisms.
CONCLUSIONS: We review currently held knowledge about the pathophysiology of the condition and the therapeutic management that is employed, including the role played by the neurologist, who must work in cooperation with other health care professionals to reach a diagnosis, dissect the physiopathogenic mechanisms at play and plan the treatment of what we hold to be a neurological disease. Future work will need to be aimed at determining the risk factors, explaining the pain mechanisms involved, drawing up a better definition of the different clinical forms and at developing complementary tests, as well as better criteria for diagnosing the condition and enhanced therapeutic algorithms.
CASE REPORTS: We report two cases of atypical presentation, both with peculiarities that have not previously appeared in the literature, in which a diagnostic suspicion and proper management favoured the patients' recovery. It is shown how treatment, especially in more severe cases, requires an early, tailored, multidisciplinary approach based on the patient's signs and symptoms as manifestations of the underlying physiopathogenic mechanisms.
CONCLUSIONS: We review currently held knowledge about the pathophysiology of the condition and the therapeutic management that is employed, including the role played by the neurologist, who must work in cooperation with other health care professionals to reach a diagnosis, dissect the physiopathogenic mechanisms at play and plan the treatment of what we hold to be a neurological disease. Future work will need to be aimed at determining the risk factors, explaining the pain mechanisms involved, drawing up a better definition of the different clinical forms and at developing complementary tests, as well as better criteria for diagnosing the condition and enhanced therapeutic algorithms.