Thermal hypesthesia in patients with complex regional pain syndrome related dystonia

Journal of Neural Transmission - Tập 118 - Trang 599-603 - 2010
Alexander G. Munts1, Monique A. van Rijn1, Erica J. Geraedts1, Jacobus J. van Hilten1, J. Gert van Dijk1, Johan Marinus1
1Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

Tóm tắt

The quantitative thermal test showed cold and warmth hypesthesia without increased heat pain sensitivity in the affected limbs of complex regional pain syndrome (CRPS) patients with tonic dystonia (n = 44) in comparison with healthy controls with a similar age and sex distribution (n = 35). The degrees of cold and warmth hypesthesia were strongly correlated. We conclude that dysfunction in small nerve fiber (i.e., C and Aδ) processing is present in patients with CRPS-related dystonia.

Tài liệu tham khảo

Albrecht PJ, Hines S, Eisenberg E, Pud D, Finlay DR, Connolly MK, Pare M, Davar G, Rice FL (2006) Pathologic alterations of cutaneous innervation and vasculature in affected limbs from patients with complex regional pain syndrome. Pain 120:244–266 Bhatia KP, Bhatt MH, Marsden CD (1993) The causalgia-dystonia syndrome. Brain 116:843–851 Birklein F, Riedl B, Sieweke N, Weber M, Neundorfer B (2000) Neurological findings in complex regional pain syndromes––analysis of 145 cases. Acta Neurol Scand 101:262–269 Burke RE, Fahn S, Marsden CD, Bressman SB, Moskowitz C, Friedman J (1985) Validity and reliability of a rating scale for the primary torsion dystonias. Neurology 35:73–77 Huge V, Lauchart M, Forderreuther S, Kaufhold W, Valet M, Azad SC, Beyer A, Magerl W (2008) Interaction of hyperalgesia and sensory loss in complex regional pain syndrome type I (CRPS I). PLoS ONE 3:e2742. doi:10.1371/journal.pone.0002742 Janig W, Baron R (2003) Complex regional pain syndrome: mystery explained? Lancet Neurol 2:687–697 Juottonen K, Gockel M, Silen T, Hurri H, Hari R, Forss N (2002) Altered central sensorimotor processing in patients with complex regional pain syndrome. Pain 98:315–323 Kemler MA, Schouten HJ, Gracely RH (2000) Diagnosing sensory abnormalities with either normal values or values from contralateral skin: comparison of two approaches in complex regional pain syndrome I. Anesthesiology 93:718–727 Magerl W, Treede RD (2004) Secondary tactile hypoesthesia: a novel type of pain-induced somatosensory plasticity in human subjects. Neurosci Lett 361:136–139 Maihofner C, Handwerker HO, Neundorfer B, Birklein F (2003) Patterns of cortical reorganization in complex regional pain syndrome. Neurology 61:1707–1715 Merskey H, Bogduk N (1994) Relatively generalized syndromes. In: Merskey H, Bogduk N (eds) Classification of chronic pain. Description of chronic pain syndromes and definitions of pain terms. IASP Press, Seattle, pp 40–43 Oaklander AL, Rissmiller JG, Gelman LB, Zheng L, Chang Y, Gott R (2006) Evidence of focal small-fiber axonal degeneration in complex regional pain syndrome-I (reflex sympathetic dystrophy). Pain 120:235–243 Pleger B, Tegenthoff M, Schwenkreis P, Janssen F, Ragert P, Dinse HR, Volker B, Zenz M, Maier C (2004) Mean sustained pain levels are linked to hemispherical side-to-side differences of primary somatosensory cortex in the complex regional pain syndrome I. Exp Brain Res 155:115–119 Rommel O, Gehling M, Dertwinkel R, Witscher K, Zenz M, Malin JP, Janig W (1999) Hemisensory impairment in patients with complex regional pain syndrome. Pain 80:95–101 Rommel O, Malin JP, Zenz M, Janig W (2001) Quantitative sensory testing, neurophysiological and psychological examination in patients with complex regional pain syndrome and hemisensory deficits. Pain 93:279–293 Schwartzman RJ, Kerrigan J (1990) The movement disorder of reflex sympathetic dystrophy. Neurology 40:57–61 Tinazzi M, Fiorio M, Fiaschi A, Rothwell JC, Bhatia KP (2009) Sensory functions in dystonia: insights from behavioral studies. Mov Disord 24:1427–1436 van der Laan L, ter Laak HJ, Gabreels-Festen A, Gabreels F, Goris RJ (1998) Complex regional pain syndrome type I (RSD): pathology of skeletal muscle and peripheral nerve. Neurology 51:20–25 van Hilten JJ, van de Beek WJ, Vein AA, van Dijk JG, Middelkoop HA (2001) Clinical aspects of multifocal or generalized tonic dystonia in reflex sympathetic dystrophy. Neurology 56:1762–1765 van Hilten JJ, Blumberg H, Schwartzman RJ (2005) Factor IV: movement disorders and dystrophy––pathophysiology and measurement. In: Wilson P, Stanton-Hicks M, Harden RN (eds) CRPS: current diagnosis and therapy, progress in pain research and management. IASP Press, Seattle, pp 119–137 van Rijn MA, Munts AG, Marinus J, Voormolen JH, de Boer KS, Teepe-Twiss IM, van Dasselaar NT, Delhaas EM, van Hilten JJ (2009a) Intrathecal baclofen for dystonia of complex regional pain syndrome. Pain 143:41–47 van Rijn MA, van Hilten JJ, van Dijk JG (2009b) Spatiotemporal integration of sensory stimuli in complex regional pain syndrome and dystonia. J Neural Transm 116:559–565 Veldman PH, Reynen HM, Arntz IE, Goris RJ (1993) Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet 342:1012–1016 Verdugo R, Ochoa JL (1992) Quantitative somatosensory thermotest. A key method for functional evaluation of small calibre afferent channels. Brain 115(Pt 3):893–913 Yarnitsky D (1997) Quantitative sensory testing. Muscle Nerve 20:198–204