Reflex Sympathetic Dystrophy Syndrome
How RSDS Affects the Brain, the Symptoms, and How to Diagnose It
Dec 1, 2008
RSDS (Reflex Sympathetic Dystrophy Syndrome) or CRPS (Complex Regional Pain Syndrome) is a chronic pain disorder involving the sympathetic nervous system. It is commonly a result of an injury or trauma (usually minor, such as a bruise, or broken bone, or a sprain), but can also be a result of a complication in a surgery, an infection, repetitive motion disorders (such as Carpal Tunnel Syndrome), and a myocardial infraction (heart attack). One of these can set off the body’s mechanism for pain recognition.
When that happens, the pain perception of the nervous system begins to misfire when responding to the trauma. As it misfires, an abnormal cycle of problematic pain begins. The pain is a disturbance in the microcirculation of the body, and therefore easily detectable by nerve conduction studies. RSDS/CRPS pain is regional, and the polysynaptic sensory fibers terminate bilaterally in the limbic system. As RSDS/CRPS progresses, the abnormal pain of the sympathetic nervous system has an effect on the rest of the body and can finalize in total disability when the muscles, bones, skin and the autonomic immune system become involved. The pain can last anywhere from as little as two weeks up to never getting rid of the pain.
How RSDS/CRPS Affects the Brain
When there is poor circulation to the brain stem (which is in most cases with RSDS patients.) memory loss, dizziness, poor focusing of eye muscles, poor balance, and migraines result. These are the problems when the disease causes constriction of the vertebral arteries. There can be constant pain in the limbic system (Frontal and Temporal lobes) which causes the memory loss, but also irritability and sometimes insomnia. Anti-depressants can be used, and are sometimes a helper in relieving the symptoms.
This disease has been clearly described twenty-five years ago by Drs. Mitchell, Moorehouse and Keen, but it remains poorly understood and is often unrecognized and misdiagnosed. There has been a lot of confusion concerning the proper terminology of CRPS. The complexity of RSDS has eluded simple terminology. Even now, at the present time, those who do not understand the disease have denied the mere existence of the disease.
The Symptoms of RSDS/CRPS
The clinical symptoms of RSDS/CRPS range from patient to patient. Pain is the first and most common complaint. It is described as extremely severe and sometimes burning and aching in nature. Swelling of the body areas and joint tenderness is visible. There can be a loss of or completely diminished motor function, as well as muscle spasms, increased sweating, severe changes in body temperature and color, and patchy osteoporosis. The skin goes through obvious changes of skin atrophy, tissue atrophy, dryness, scaling, increased hair growth or hair loss, and nail changes can be seen. When in the upper body, there may be associated pain and limitation in the motion of the shoulders.
RSDS/CRPS can be as painful as cancer, as costly as AIDS, and as crippling as arthritis. The hyperpathic pain is the most common sort of pain in patients. This is an intense, usually persistent, and burning regional pain. The pain is usually out of proportion to the severity of the trauma. Simple stimulation of the involved areas originating the hyperplasia may be attended by signs of a rise in the pulse. In addition, the hyperpathic pain is accompanied by a regional mild hypoesthesia to touch and pain.
How RSDS/CRPS can be Diagnosed
RSDS/CRPS can be diagnosed at a clinical evaluation, an x-ray, an EMG, a CAT scan or different MRI studies. It can also be found with Thermograph studies, a series of Sympathetic Blockades, Photon absorptimetry, a 3-phase radionuclide bone scanning, a cold stressor test, obvious changes in synovial fluid in joints, and a galvanic skin test which measures the pain threshold. All of these can be done at a hospital, but if needed, a specialist can be used instead. There are four stages to the severity of RSDS/CRPS. The stages range from extremely mild to overly severe. In the fourth stage, disability is the outcome. Patients with stage four RSDS/CRPS are confined to a wheelchair, and are also bedridden.
RSDS/CRPS affects young people as well as old. It is common in children, usually with good prognosis; but it is not usually diagnosed in time, if at all. The disease does not discriminate, affecting both genders from all races of people. A study has shown that more than half of the patients are women. With more research, this disease can one day be diagnosable and understood by all doctors.
Sources
Healthcommunities.com. Reflex Sympathetic Dystrophy (RSD). Stanley J. Swierzewski III, M.D. 1998. Johnson & Johnson, Inc., Ortho-McNeil, Inc., Ortho-Biotech, Inc., and Medtronic, Inc. March 9, 2005.
O’Donnell, Jim. An RSD/CRPS Site. Jim O’Donnell. 1999.
RSDHope. American RSDHope. 1997. NEPC Internet Services. March 9, 2005.
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