Neuro-algodystrophy: A psychiatrist's view

Abstract

In this article the syndrome of neuro-algodystrophy is discussed from a psychiatric point of view. First, a review is given of the scarce psychological literature on this subject. Secondly, a retrospective study of 32 neuro-algodystrophy patients, seen in a psychiatric consultation practice, is presented; in nearly all cases of this highly selected group, an obvious time-relation with a significant psychological factor could be determined, and in more than 60%, some kind of affective loss was concerned. Thirdly, some theoretical speculations about these findings are formulated. Finally, it is concluded that the diagnostic and therapeutic contribution of the psychiatrist may be valuable, at least in some cases of neuro-algodystrophy.

Diagnosis and management of algodystrophy.

“…A subgroup probably does have a psychiatric disorder as a factor in both the precipitation and perpetuation of the condition, though cause and effect are difficult to distinguish. 12 Alternative local tissue mechanisms have recently been proposed as being important, whereby a series of vicious circles is established, in which vasodilatation, low flow, and persistent stimulation of nociceptors all play a part. 13 The authors also suggest that alteration in adrenoceptors may be involved.…”

Reflex Sympathetic Dystrophy

“…Data characterizing the individual UTEs were tabulated and tallied in spreadsheet fashion. Each UTE was analyzed for these “special traits:” vasospasm, pain, ugly or necrotic ulcer, large ulcer (25 cm 2 or larger), multiple ulcers, ectopic ulcer, stasis dermatitis, folliculitis, compression intolerance, movement disorder, precipitating trauma, and personality disorder. For each UTE, the score was arrived at by adding the number of special traits present, the highest possible score being 12.…”

“…These observations and the intriguing questions they raised changed the informal review into a detailed analysis. The list of special traits to be studied was expanded to include four additional ones recognized as belonging to the RSD syndrome, namely vasospasm, precipitating trauma, personality disorder, and movement disorder 1–4 …”

Controversies surrounding reflex sympathetic dystrophy: A review article

“…In adolescents and children with RSD, trauma is mostly psychic and has been considered by some to be the peripheral equivalent of migraine [72]. Preexisting psychological (personality) factors and psychoneurosis [73] have been regularly described in these patients [25,[73][74][75][76], and a susceptible population thus exists [74,76]. Overt parental conflict is found in a high incidence in this patient group [25,76] but is also found in stable, but overly close, cohesive families, in which the child is stressed in attempting to meet parental demands [25].…”