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Blumberg H. Zur Entstehung und Therapie des Schmerzsyndroms bei der sympathischen Reflexdystrophie : Klinisches Bild, experimentelle Untersuchungen und neue pathophysiologische Vorstellungen. [Development and therapy of the pain syndrome of reflex sympathetic dystrophy. Clinical expression, experimental investigations, and new pathophysiological considerations.]. Schmerz. 1988;2(3):125-43doi: 10.1007/BF02528612.
Blumberg, H. (1988). Zur Entstehung und Therapie des Schmerzsyndroms bei der sympathischen Reflexdystrophie : Klinisches Bild, experimentelle Untersuchungen und neue pathophysiologische Vorstellungen. [Development and therapy of the pain syndrome of reflex sympathetic dystrophy. Clinical expression, experimental investigations, and new pathophysiological considerations.]. Schmerz (Berlin, Germany), 2(3), 125-43. https://doi.org/10.1007/BF02528612
Blumberg, H. "Zur Entstehung und Therapie des Schmerzsyndroms bei der sympathischen Reflexdystrophie : Klinisches Bild, experimentelle Untersuchungen und neue pathophysiologische Vorstellungen." [Development and therapy of the pain syndrome of reflex sympathetic dystrophy. Clinical expression, experimental investigations, and new pathophysiological considerations.]. Schmerz (Berlin, Germany) vol. 2,3 (1988): 125-43. doi: https://doi.org/10.1007/BF02528612
Blumberg H. Zur Entstehung und Therapie des Schmerzsyndroms bei der sympathischen Reflexdystrophie : Klinisches Bild, experimentelle Untersuchungen und neue pathophysiologische Vorstellungen. [Development and therapy of the pain syndrome of reflex sympathetic dystrophy. Clinical expression, experimental investigations, and new pathophysiological considerations.]. Schmerz. 1988 Sep;2(3):125-43. doi: 10.1007/BF02528612. German. PMID: 18415324.
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Schmerz. 1988 Sep;2(3):125-43. doi: 10.1007/BF02528612.

[Development and therapy of the pain syndrome of reflex sympathetic dystrophy. Clinical expression, experimental investigations, and new pathophysiological considerations.].

Schmerz (Berlin, Germany)

[Article in German]
H Blumberg

Affiliations

  1. Neurologische Klinik und Poliklinik Albert Ludwigs-Universität, Hansastraße 9, D-7800, Freiburg i. Br..

PMID: 18415324 DOI: 10.1007/BF02528612

Abstract

Reflex sympathetic dystrophy (RSD) is a disease of the extremities that can be elicited by different factors, occurring at different sites (e.g., trauma, herpes zoster, myocardial infarction). Independently of its etiology, however, the clinical symptoms of RSD are found most often in distal parts of the extremities affected (hand or foot). In a generalized distribution pattern, the following signs, representing a triad of autonomic, motoric and sensory disturbances, are commonly observed in these regions: 1. dysregulation of blood flow to the skin and of sweating, together with diffuse swelling, 2. impairment of movement and muscular strength; 3. diffuse sensory skin disturbances and spontaneous pain of ariable character (e.g., burning, throbbing, aching, shooting). Pain sensation is generally diffuse; in most cases it is deep and less often, superficial (probably representing bone or skin pain, respectively). This triad occurs at the very onset of RSD. If the distribution pattern is generalized, it can be used as a diagnostic criterion for RSD. Our experimental results support the idea of disturbances of skin blood flow related to abnormal vasoconstrictor outflow. This assumption is primarily based on two observations: 1. 73% of 97 RSD patients (upper extremity affected) showed systematic side differences in fingertip temperatures at room temperature. All points measured on the affected side had higher (n=51) or lower (n= 20) temperature values than corresponding sites on the healthy extremity. Such systematic side differences were found only in 16% out of 79 healthy subjects (p

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