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Reflex Sympathetic Dystrophy (Reflex Sympathetic Dystrophy Syndrome)

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A syndrome characterized by severe burning pain in an extremity accompanied by sudomotor, vasomotor, and trophic changes in bone without an associated specific nerve injury. This condition is most often precipitated by trauma to soft tissue or nerve complexes. The skin over the affected region is usually erythematous and demonstrates hypersensitivity to tactile stimuli and erythema. (Adams et al., Principles of Neurology, 6th ed, p1360; Pain 1995 Oct;63(1):127-33)

Also Known As:

Reflex Sympathetic Dystrophy Syndrome; Syndrome, Reflex Sympathetic Dystrophy; Syndrome, Shoulder-Hand; Algodystrophic Syndrome; CPRS Type I; Cervical Sympathetic Dystrophy; Pain Syndrome Type I, Complex Regional; RSD (Reflex Sympathetic Dystrophy); Sudek's Atrophy; Sympathetic Reflex Dystrophia; Type I Complex Regional Pain Syndrome; Algodystrophies; Atrophies, Sudek's; Atrophy, Sudek; Atrophy, Sudek's; CPRS Type Is; Cervical Sympathetic Dystrophies; Dystrophies, Cervical Sympathetic; Dystrophies, Reflex Sympathetic; Dystrophy, Cervical Sympathetic; Dystrophy, Reflex Sympathetic; I, CPRS Type; Is, CPRS Type; RSDs (Reflex Sympathetic Dystrophy); Reflex Dystrophia, Sympathetic; Reflex Sympathetic Dystrophies; Shoulder Hand Syndrome; Shoulder-Hand Syndromes; Sudek's Atrophies; Sudeks Atrophy; Sympathetic Dystrophies, Cervical; Sympathetic Dystrophies, Reflex; Sympathetic Dystrophy, Cervical; Sympathetic Dystrophy, Reflex; Sympathetic Reflex Dystrophias; Syndrome, Algodystrophic; Syndromes, Shoulder-Hand; Type I, CPRS; Type Is, CPRS; Algodystrophy; Complex Regional Pain Syndrome, Type I; Pain Syndrome Type I, Regional, Complex; Shoulder-Hand Syndrome; Sudek Atrophy

Networked: 514 relevant articles (34 outcomes, 37 trials/studies)

Relationship Network

Disease Context: Research Results

Nervous System Diseases: 6158
- Neuromuscular Diseases: 1068
  - Peripheral Nervous System Diseases: 5557
    - Complex Regional Pain Syndromes: 14
      - Reflex Sympathetic Dystrophy: 514
- Autonomic Nervous System Diseases: 28
  - Complex Regional Pain Syndromes: 14
    - Reflex Sympathetic Dystrophy: 514

Related Diseases

1.	Pain (Aches)
2.	Hyperhidrosis
3.	Causalgia (Syndrome, Causalgia)
4.	Neoplasms (Cancer)
5.	Ischemia

Experts

1.	Adami, Silvano: 4 articles (07/2014 - 10/2009)
2.	Kingery, Wade S: 4 articles (08/2009 - 03/2004)
3.	Guo, Tian-Zhi: 4 articles (08/2009 - 03/2004)
4.	Bodde, Marlies I: 3 articles (01/2014 - 10/2011)
5.	Dijkstra, Pieter U: 3 articles (01/2014 - 10/2011)
6.	Idolazzi, Luca: 3 articles (03/2013 - 10/2009)
7.	Gatti, Davide: 3 articles (03/2013 - 10/2009)
8.	Zhao, Rong: 3 articles (08/2009 - 08/2008)
9.	Taira, T: 3 articles (01/2007 - 01/2003)
10.	Hori, T: 3 articles (01/2007 - 01/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Reflex Sympathetic Dystrophy:

1.	Guanethidine FDA Link 12/01/1991 - "The regional guanethidine blocks seemed to be a good treatment for algodystrophy after failure of other treatments." 07/01/1983 - "Regional intravenous guanethidine vs. stellate ganglion block in reflex sympathetic dystrophies: a randomized trial." 06/15/2001 - "Use of intravenous guanethidine for the treatment of complex regional pain syndrome type I is of variable efficacy. " 11/01/1996 - "Intravenous regional guanethidine Bier block (IVRGBB) has been used predominantly in Europe for treating reflex sympathetic dystrophy (RSD). " 11/01/1996 - "Intravenous guanethidine in patients with reflex sympathetic dystrophy."
2.	pamidronate (APD)FDA LinkGeneric 09/01/2004 - "Efficacy of pamidronate in complex regional pain syndrome type I." 12/01/2001 - "To evaluate the efficacy of treatment with pamidronate in reflex sympathetic dystrophy (RSD) refractory to previous treatment. " 01/01/1997 - "The objective of the study was to assess the efficacy and the safety of pamidronate (APD) in recalcitrant reflex sympathetic dystrophy (RSD). " 12/01/2001 - "Treatment of reflex sympathetic dystrophy with pamidronate: 29 cases." 10/01/2000 - "Intravenous pamidronate for treatment of reflex sympathetic dystrophy during breast feeding."
3.	Calcitonin (Calcitonin, Eel)FDA LinkGeneric 09/01/2002 - "Subsequently, right lower limb reflex sympathetic dystrophy developed, which was confirmed by scintigraphy and responded well to calcitonin treatment. " 10/01/1996 - "Calcitonin treatment in reflex sympathetic dystrophy: a preliminary study." 05/01/2002 - "Calcitonin in reflex sympathetic dystrophy syndrome and other painful conditions." 09/01/2001 - "[Experiences with calcitonin treatment of patients with type I complex regional pain syndrome (CRPS I--Sudeck disease)]." 08/01/1992 - "The use of intranasal calcitonin in the treatment of algodystrophy."
4.	gabapentin (Neurontin)FDA LinkGeneric 03/01/2000 - "The first reported case of a child with a diagnosis of reflex sympathetic dystrophy who was treated successfully with gabapentin is presented." 03/01/2000 - "Gabapentin, a new antiepileptic medication, has been demonstrated to be effective in adults with reflex sympathetic dystrophy. " 04/01/2007 - "The objective of this paper is to investigate the effect of gabapentin in the earlier stage of reflex sympathetic dystrophy syndrome (RSD). " 04/01/2007 - "The effect of gabapentin in earlier stage of reflex sympathetic dystrophy." 07/01/2006 - "A case of recurrent and migratory complex regional pain syndrome type I: Prevention by gabapentin."
5.	Capsaicin (Zostrix)FDA Link 06/01/2001 - "Complex regional pain syndrome type I treated with topical capsaicin: a case report." 09/01/1990 - "Treatment of reflex sympathetic dystrophy with topical capsaicin. " 09/01/1990 - "A 31-year-old woman with intractable reflex sympathetic dystrophy experienced nearly complete, though temporary, resolution of pain following 3 weeks of topical capsaicin. " 06/01/1998 - "Uncontrolled studies and case reports have indicated that pain or dysfunction was less at the end of capsaicin therapy for neck pain, loin pain/hematuria syndrome, oral mucositis, rhinopathy, reflex sympathetic dystrophy syndrome, detrusor hyperreflexia, and cutaneous pain due to tumor of the skin. " 04/01/1991 - "Clinical investigations of topical capsaicin include trials in chronic pain syndromes such as postherpetic neuralgia, postmastectomy neuroma, reflex sympathetic dystrophy syndrome, diabetic neuropathy, rheumatoid arthritis, psoriasis, hemodialysis-associated itching, and vulvar vestibulitis. "
6.	Reserpine (Serpasil)FDA Link 09/01/1994 - "[Treatment with sympathetic intravenous block with reserpine in work-related reflex sympathetic dystrophy]." 01/01/1983 - "[Treatment of reflex algodystrophy by intravenous reserpine block]." 12/01/1982 - "[Importance of intravenous reserpine in the treatment of reflex sympathetic dystrophy]." 12/01/1981 - "Intravenous reserpine for treatment of reflex sympathetic dystrophy." 07/01/1980 - "Treatment of reflex sympathetic dystrophy with regional intravenous reserpine."
7.	Dimethyl Sulfoxide (DMSO)FDA LinkGeneric 03/06/1993 - "[Good results of treatment of reflex sympathetic dystrophy with a 50% dimethylsulfoxide cream]." 03/01/1996 - "Treatment of acute reflex sympathetic dystrophy with DMSO 50% in a fatty cream." 01/01/2003 - "To determine the cost effectiveness and cost utility of acetylcysteine versus dimethyl sulfoxide (DMSO) for patients with reflex sympathetic dystrophy (RSD), from a societal viewpoint. " 01/01/2003 - "Cost effectiveness and cost utility of acetylcysteine versus dimethyl sulfoxide for reflex sympathetic dystrophy." 03/06/1993 - "In this open prospective study dimethyl sulfoxide (DMSO), a hydroxyl radical scavenger, was tested in a 50% concentration in a fatty cream base (cremor vaselini cetomacrogolis FNA) in a total of 37 patients suffering from reflex sympathetic dystrophy. "
8.	Clodronic Acid (Clodronate)IBA 06/01/2000 - "Intravenous clodronate in the treatment of reflex sympathetic dystrophy syndrome. " 01/01/2009 - "Efficacy of intramuscular clodronate in Complex Regional Pain Syndrome type I: description of a case located in the astragalus in a patient with psoriatic arthritis." 06/01/2000 - "To evaluate the efficacy of intravenous (i.v.) clodronate in patients with reflex sympathetic dystrophy syndrome (RSDS) and to assess the urinary excretion of type I collagen crosslinked N-telopeptide (NTx) before and after the treatment. " 04/01/2005 - "Three second-generation BPs were tested in the treatment of reflex sympathetic dystrophy: pamidronate, alendronate and clodronate. "
9.	salmon calcitonin (Calcimar)FDA LinkGeneric 02/01/1992 - "The efficacy of intranasal salmon calcitonin was examined in a double-blind randomized study in reflex sympathetic dystrophy. " 07/31/1991 - "All patients with algodystrophy were treated with salmon calcitonin (100 U.I./die/i.m. " 10/01/1996 - "In this study, the aim was to investigate the effects of salmon calcitonin treatment in reflex sympathetic dystrophy that develops in hemiplegia. " 02/01/1977 - "MRC of salmon calcitonin or 160 1. mrc of pork calcitonin in 117 subjects (58 patients with Paget's disease, 22 with osteoporosis, 22 with Sudeck-Leriche algodystrophy and 15 control subjects). " 05/01/2002 - "Salmon calcitonin (especially intranasal) provides an interesting analgesic effect in a series of painful conditions including reflex sympathetic dystrophy syndrome, adhesive capsulitis, ankylosing spondylitis, rheumatoid arthritis, vertebral crush fractures and metastasis, phantom limb pain, etc. In addition, in preliminary series, calcitonin shows an unexpected benefit to vasomotor changes and peptic ulcer. "
10.	OxygenIBA 12/01/1995 - "Hyperbaric oxygen and the reflex sympathetic dystrophy syndrome: a case report." 04/01/1993 - "The impairment of high energy phosphate metabolism, as deduced from the NMR data, may be caused by cellular hypoxia or diminished oxygen utilization, which would agree with previous findings that oxygen extraction is reduced in extremities affected by reflex sympathetic dystrophy." 03/01/2012 - "The purpose of this study was to evaluate oxygen extraction and utilization in end stage chronic complex regional pain syndrome type I (CRPS I) patients undergoing amputation and to relate these to muscle histology of the amputated limb. " 07/01/2004 - "To verify the reproducibility of measurement of transcutaneous oxygen tension (TcPo(2)) on the back of the hand in control subjects and stroke patients in the assessment of the complex regional pain syndrome type I (CRPS I). " 03/01/2001 - "Several reports suggest the usefulness of transcutaneous oxygen tension (TcPO(2)) in assessing the shoulder hand syndrome in stroke patients. "

Therapies and Procedures

1.	Sympathectomy (Sympathectomies) 07/01/1949 - "A case of reflex sympathetic dystrophy relieved by sympathectomy." 02/01/2002 - "Surgical sympathectomy for reflex sympathetic dystrophy syndromes." 10/01/1999 - "It is a lie that sympatholysis may specifically cure patients with unqualified "reflex sympathetic dystrophy." This was already stated by the father of sympathectomy, René Leriche, more than half a century ago. " 09/01/1997 - "Successful treatment of recurrent reflex sympathetic dystrophy with bilateral lumbar sympathectomies." 08/01/1997 - "An 11-year-old girl with reflex sympathetic dystrophy successfully treated by thoracoscopic sympathectomy."
2.	Electroacupuncture 10/01/2009 - "Algodystrophy treated with needle-free electroacupuncture and raw Chinese herbal decoction: a case report and review of literature." 07/01/1991 - "Electroacupuncture's role in the management of reflex sympathetic dystrophy." 07/01/1991 - "Reflex sympathetic dystrophy and electroacupuncture." 02/01/2012 - "Meta-analysis showed that simple acupuncture therapy is significantly superior to acupoint block therapy for relieving shoulder-hand syndrome [odds ratio (OR, 95% CI) 4.80 (2.02 to 11.41), P < 0.05]; electroacupuncture therapy is markedly more effective than simple acupuncture therapy [OR (95% CI) 4.60 (2.08 to 10. " 07/01/2007 - "[Clinical observation on penetration needling combined with electroacupuncture for treatment of post-stroke shoulder-hand syndrome]."
3.	Acupuncture Points (Acupuncture Point) 06/01/1983 - "Use of electrical stimulation at acupuncture points for the treatment of reflex sympathetic dystrophy in a child. " 02/01/2012 - "Meta-analysis showed that simple acupuncture therapy is significantly superior to acupoint block therapy for relieving shoulder-hand syndrome [odds ratio (OR, 95% CI) 4.80 (2.02 to 11.41), P < 0.05]; electroacupuncture therapy is markedly more effective than simple acupuncture therapy [OR (95% CI) 4.60 (2.08 to 10. " 03/01/2005 - "She complained of pain referred to the left arm and associated circulatory and sensory disturbance in keeping with the diagnosis of complex regional pain syndrome type I. Traditional Chinese and Western trigger point acupuncture techniques were used in order to treat her pain and autonomic dysfunction. " 06/01/2014 - "To evaluate the therapeutic effect of warm acupuncture (moxa-heated acupuncture) needle stimulation of Waiguan (TE 5) acupoint in the treatment of shoulder-hand syndrome (phase I) in patients with stroke. "
4.	Acupuncture Therapy 02/01/2012 - "To assess the effectiveness of acupuncture therapy for shoulder-hand syndrome. " 03/01/2009 - "The clinical therapeutic effect of the opposing needling is better than that of routine acupuncture therapy for treatment of poststroke shoulder hand syndrome." 02/01/2012 - "Meta-analysis showed that simple acupuncture therapy is significantly superior to acupoint block therapy for relieving shoulder-hand syndrome [odds ratio (OR, 95% CI) 4.80 (2.02 to 11.41), P < 0.05]; electroacupuncture therapy is markedly more effective than simple acupuncture therapy [OR (95% CI) 4.60 (2.08 to 10. " 01/01/1990 - "After wound healing, persistent pain frequently is treated with continued analgesic administration, physical therapy, acupuncture, nerve blocks, psychotherapy and sometimes even ignored in hopes that either the pain or the patient will "go away." The authors relate successful evaluation and treatment of reflex sympathetic dystrophy in the case of a young man with disabling pain following a healed crush injury to his foot."
5.	Oral Administration 01/01/2011 - "We believe low-dose oral administration of bisphosphonate is worth considering for the treatment of idiopathic complex regional pain syndrome type I accompanied by regional osteoporotic change." 07/01/2008 - "Treatment system for reflex sympathetic dystrophy is composed of medicament therapy including oral administration and/or injection of drug, physical therapy such as thermotherapy and gently passive movement, surgical treatment and psychotherapy. " 04/01/2013 - "With floating acupuncture, shoulder pain was relieved and the daily life activity was improved in the patients with post-stroke shoulder-hand syndrome, which was superior to the oral administration of western medicine and local Chinese herbs fumigation (P < 0.01). " 04/01/2013 - "The floating acupuncture relieves shoulder pain of the patients with post-stroke shoulder-hand syndrome promptly and effectively, and the effects on shoulder pain and the improvements of daily life activity are superior to that of the oral administration of western medicine and local Chinese herbs fumigation." 04/01/2013 - "To compare the efficacy difference in the treatment of shoulder pain in post-stroke shoulder-hand syndrome among floating acupuncture, oral administration of western medicine and local fumigation of Chinese herbs. "