Tremor in Reflex Sympathetic Dystrophy

Deuschl, Günther; Blumberg, H.; Lücking, Carl Hermann

doi:10.1001/archneur.1991.00530240051018

Cited by 105 publications

(46 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This raises the question whether the nonpainful sensations elicited from muscle and joints are also changed. s Somatomotor changes About 50 % of patients with CRPS I show a decrease of active range of motion, increased amplitude of physiological tremor, and reduced active motor force in the affected extremity [18,57,58,69]. Fig.…”

Section: Sympathetic Neurons and Edemamentioning

confidence: 99%

Complex regional pain syndrome is a disease of the central nervous system

Jänig

Baron

2002

Clinical Autonomic Research

179

View full text Add to dashboard Cite

Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, trophic changes of skin, appendages of skin and subcutaneous tissues, and active and passive movement disorders. It is classified into type I (previously reflex sympathetic dystrophy) and type II (previously causalgia). Based on multiple evidence from clinical observations, experimentation on humans, and experimentation on animals, the hypothesis has been put forward that CRPS is primarily a disease of the central nervous system. CRPS patients exhibit changes which occur in somatosensory systems processing noxious, tactile and thermal information, in sympathetic systems innervating skin (blood vessels, sweat glands), and in the somatomotor system. This indicates that the central representations of these systems are changed and data show that CRPS, in particular type I, is a systemic disease involving these neuronal systems. This way of looking at CRPS shifts the attention away from interpreting the syndrome conceptually in a narrow manner and to reduce it to one system or to one mechanism only, e.g., to sympathetic-afferent coupling. It will further our understanding why CRPS type I may develop after a trivial trauma, after a trauma being remote from the affected extremity exhibiting CRPS, and possibly after immobilization of an extremity. It will explain why, in CRPS patients with sympathetically maintained pain, a few temporary blocks of the sympathetic innervation of the affected extremity sometimes lead to long-lasting (even permanent) pain relief and to resolution of the other changes observed in CRPS. This changed view will bring about a diagnostic reclassification and redefinition of CRPS and will have bearings on the therapeutic approaches. Finally it will shift the focus of research efforts.

show abstract

Section: Sympathetic Neurons and Edemamentioning

confidence: 99%

Complex regional pain syndrome is a disease of the central nervous system

Jänig

Baron

2002

Clinical Autonomic Research

179

View full text Add to dashboard Cite

show abstract

“…About half of the patients have a postural or action tremor that represents an increased physiological tremor. 40 In about 10% of cases, dystonia develops in the affected hand or foot. 11,110,145 Postsympathectomy Neuralgia.…”

mentioning

confidence: 99%

Causalgia and reflex sympathetic dystrophy: Does the sympathetic nervous system contribute to the generation of pain?

1999

View full text Add to dashboard Cite

“…Genauere Angaben zum Bewertungsmaß-stab oder zur Quantifizierung der Störung finden sich jedoch nicht. Einige Arbeiten beschäftigen sich ausführlicher mit Teilaspekten, wie Tremor [11], Muskelspasmen [23] oder Dystonie [5,30].…”

Section: Diskussionunclassified

“…Am häufigsten fanden sich Bewegungseinschränkungen bis hin zu Kontrakturen sowie bei 50% der Patienten ein Tremor; dies stimmt bezüglich der Häufigkeit gut mit den Ergebnissen von Deuschl et al [11] überein. Dystone Bewegungsmuster im eigentlichen Sinn fanden sich in der vorliegenden Untersuchung lediglich bei 2 Patienten (5%) und standen auch bei den betroffenen Patienten nicht im Vordergrund der motorischen Symptomatik, sondern waren eher als Begleitphänomen zu werten.…”

Section: Diskussionunclassified