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Ann Rehabil Med. 2015 Feb;39(1):116-21. doi: 10.5535/arm.2015.39.1.116. Epub 2015 Feb 28.

Predictive value of sympathetic skin response in diagnosing complex regional pain syndrome: a case-control study.

Annals of rehabilitation medicine

Hyun Jung Kim, Hea Eun Yang, Dae Hyun Kim, Yoon Ghil Park

Affiliations

  1. Department of Rehabilitation Medicine, Gangnam Severance Hospital, Seoul, Korea. ; Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea.
  2. Veteran Health Service Medical Center, Seoul, Korea.

PMID: 25750880 PMCID: PMC4351482 DOI: 10.5535/arm.2015.39.1.116

Abstract

OBJECTIVE: To investigate the predictive value of the sympathetic skin response (SSR) in diagnosing complex regional pain syndrome (CRPS) by comparing three diagnostic modalities-SSR, three-phasic bone scans (TPBS), and thermography.

METHODS: Thirteen patients with severe limb pain were recruited. Among them, 6 were diagnosed with CRPS according to the proposed revised CRPS clinical diagnostic criteria described by the International Association for the Study of Pain. SSR was measured in either the hands or feet bilaterally and was considered abnormal when the latency was prolonged. A positive TPBS finding was defined as diffuse increased tracer uptake on the delayed image. Thermographic findings were considered positive if a temperature asymmetry greater than 1.00℃ was detected between the extremities.

RESULTS: Five of 6 CRPS patients showed prolonged latency on SSR (83% sensitivity). TPBS was positive in the 5 CRPS patients who underwent TPBS (100% sensitivity). Thermography was positive in 4 of 5 CRPS patients who underwent the procedure (80% sensitivity). The remaining 7 non-CRPS patients differed on examination. SSR latencies within normal limit were noted in 4 of 7 non-CRPS patients (57% specificity). Results were negative in 4 of 5 non-CRPS patients who underwent TPBS (80% specificity), and negative in 3 of 5 non-CRPS patients who underwent thermography (60% specificity).

CONCLUSION: SSR may be helpful in detecting CRPS.

Keywords: Complex regional pain syndromes; Galvanic skin response; Radionuclide imaging; Thermography

References

  1. Electroencephalogr Clin Neurophysiol. 1992 Jun;85(3):225-7 - PubMed
  2. J Clin Neurophysiol. 1994 Sep;11(5):519-24 - PubMed
  3. Neurol India. 2006 Sep;54(3):279-82 - PubMed
  4. J Neurol Sci. 1985 Feb;67(2):239-51 - PubMed
  5. J Neurol Neurosurg Psychiatry. 1967 Aug;30(4):319-24 - PubMed
  6. Muscle Nerve. 1993 Sep;16(9):930-4 - PubMed
  7. J Neurol Sci. 1993 Aug;118(1):88-91 - PubMed
  8. J Neurol Neurosurg Psychiatry. 1962 May;25:126-33 - PubMed
  9. Pain. 1995 Oct;63(1):127-33 - PubMed
  10. Eur J Pain. 2011 Sep;15(8):830.e1-8 - PubMed
  11. Acta Neurol Scand. 2000 Apr;101(4):262-9 - PubMed
  12. Autoimmun Rev. 2014 Mar;13(3):242-65 - PubMed
  13. Muscle Nerve. 1987 Oct;10(8):711-6 - PubMed
  14. Pain. 1991 Jul;46(1):17-22 - PubMed
  15. Am J Surg. 1959 Apr;97(4):454-65 - PubMed
  16. Pain Med. 2007 May-Jun;8(4):326-31 - PubMed
  17. J Neurol Neurosurg Psychiatry. 1992 Oct;55(10):902-8 - PubMed
  18. J Neurol Sci. 1988 Nov;87(2-3):299-306 - PubMed
  19. Arch Neurol. 1990 Jun;47(6):659-64 - PubMed
  20. J Orthop Surg (Hong Kong). 2006 Dec;14 (3):284-90 - PubMed
  21. Muscle Nerve. 1988 Mar;11(3):261-4 - PubMed
  22. Lancet. 1993 Oct 23;342(8878):1012-6 - PubMed
  23. Biomed Eng Online. 2006 May 12;5:30 - PubMed
  24. Arch Neurol. 1991 Sep;48(9):912-5 - PubMed
  25. Clin Auton Res. 2003 Aug;13(4):256-70 - PubMed
  26. Lancet Neurol. 2011 Jul;10(7):637-48 - PubMed
  27. Muscle Nerve. 1991 Nov;14(11):1074-9 - PubMed
  28. Zhonghua Yi Xue Za Zhi (Taipei). 2000 Mar;63(3):189-95 - PubMed
  29. Br J Anaesth. 2012 Apr;108(4):655-61 - PubMed
  30. Clin J Pain. 2007 Jun;23 (5):449-57 - PubMed
  31. Mov Disord. 1993 Apr;8(2):151-7 - PubMed
  32. Pain. 2007 Sep;131(1-2):153-61 - PubMed
  33. J Neurol Neurosurg Psychiatry. 1984 May;47(5):536-42 - PubMed
  34. Clin Auton Res. 2009 Dec;19(6):355-62 - PubMed
  35. Pain. 2012 Apr;153(4):765-74 - PubMed

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