Sensory signs in complex regional pain syndrome and peripheral nerve injury
Summary QST revealed more similarities than differences between CRPS-I, CRPS-II, and PNI: sensory loss occurred in 63% of CRPS-I and sensory gain in 81% of PNI patients. This study determined patterns of sensory signs in complex regional pain syndrome (CRPS) type I and II and peripheral nerve injury...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2012
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| In: |
Pain
Year: 2011, Volume: 153, Issue: 4, Pages: 765–774 |
| ISSN: | 1872-6623 |
| DOI: | 10.1016/j.pain.2011.11.009 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1016/j.pain.2011.11.009 Verlag, Volltext: https://journals.lww.com/pain/pages/articleviewer.aspx?year=2012&issue=04000&article=00009&type=abstract 
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| Author Notes: | Janne Gierthmühlen, Christoph Maier, Ralf Baron, Thomas Tölle, Rolf-Detlef Treede, Niels Birbaumer, Volker Huge, Jana Koroschetz, Elena K. Krumova, Meike Lauchart, Christian Maihöfner, Helmut Richter, Andrea Westermann, the German Research Network on Neuropathic Pain (DFNS) study Group |
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| 245 | 1 | 0 | |a Sensory signs in complex regional pain syndrome and peripheral nerve injury |c Janne Gierthmühlen, Christoph Maier, Ralf Baron, Thomas Tölle, Rolf-Detlef Treede, Niels Birbaumer, Volker Huge, Jana Koroschetz, Elena K. Krumova, Meike Lauchart, Christian Maihöfner, Helmut Richter, Andrea Westermann, the German Research Network on Neuropathic Pain (DFNS) study Group |
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| 520 | |a Summary QST revealed more similarities than differences between CRPS-I, CRPS-II, and PNI: sensory loss occurred in 63% of CRPS-I and sensory gain in 81% of PNI patients. This study determined patterns of sensory signs in complex regional pain syndrome (CRPS) type I and II and peripheral nerve injury (PNI). Patients with upper-limb CRPS-I (n = 298), CRPS-II (n = 46), and PNI (n = 72) were examined with quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain. The majority of patients (66%-69%) exhibited a combination of sensory loss and gain. Patients with CRPS-I had more sensory gain (heat and pressure pain) and less sensory loss than patients with PNI (thermal and mechanical detection, hypoalgesia to heat or pinprick). CRPS-II patients shared features of CRPS-I and PNI. CRPS-I and CRPS-II had almost identical somatosensory profiles, with the exception of a stronger loss of mechanical detection in CRPS-II. In CRPS-I and -II, cold hyperalgesia/allodynia (28%-31%) and dynamic mechanical allodynia (24%-28%) were less frequent than heat or pressure hyperalgesia (36%-44%, 67%-73%), and mechanical hypoesthesia (31%-55%) was more frequent than thermal hypoesthesia (30%-44%). About 82% of PNI patients had at least one type of sensory gain. QST demonstrates more sensory loss in CRPS-I than hitherto considered, suggesting either minimal nerve injury or central inhibition. Sensory profiles suggest that CRPS-I and CRPS-II may represent one disease continuum. However, in contrast to recent suggestions, small fiber deficits were less frequent than large fiber deficits. Sensory gain is highly prevalent in PNI, indicating a better similarity of animal models to human patients than previously thought. These sensory profiles should help prioritize approaches for translation between animal and human research. | ||
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