Complex Regional Pain Syndrome

Abstract

Complex regional pain syndrome (CRPS) is still a poorly understood disorder which pathophysiological mechanisms include the autonomic, sensory and motor systems as well as cortical areas involved in the processing of cognitive and affective information. The main CRPS clinical symptoms are pain and hyperalgesia, vasomotor, sudomotor and trophic changes in the affected extremity. In addition, motor symptoms are usually present from the beginning, and may progress with ongoing duration. CRPS patients exhibit changes that occur in somatosensory systems processing noxious, tactile and thermal information, in sympathetic systems innervating skin (blood vessels, sweat glands) and in the somatomotor system. The most common approach to the treatment of CRPS combines sequential trials of analgesic drugs with rehabilitative and psychological interventions. Invasive techniques like sympathetic blocks, spinal cord stimulation, etc. have limited roles in CRPS. (Archives of Neuropsychiatry 2009; 46: 70-5)