SEARCH RESULTS FOR: Complex-Regional-Pain-Syndrome

Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS): Pathogenesis and clinical findings Type 1 origin: CRPS arises spontaneously or from trauma without confirmed damage to nerves (e.g. surgery, nerve compression, fracture, tissue trauma, ischemia, sprain) Type 2 origin: CRPS arises from trauma with confirmed evidence of nerve damage Intense psychological stress is associated with ↑ severity of CRPS Peripheral nerve endings release ↑ levels of neuropeptides (e.g. substance P, bradykinin, calcitonin gene-related peptide) Vasodilation & protein extravasation in tissues ↑ Perfusion to motor cortex ↓ Grey matter volume in cortical pain regions ↓ Cortical grey matter volume & ↓ perfusion of cortex in limbic & sensorimotor areas Dysregulation of sympathetic nerve fibres Autonomic dysfunction Central nerve fibres ↑ release of proinflammatory cytokines while ↓ release of anti- inflammatory cytokines Central sensitization (threshold at which a central nerve transmits a signal is lowered so that it more readily transmits signals) Mechanical hyperalgesia (hallmark of central sensitization) Authors: Jessica Hammal Calvin Howard Reviewers: Sina Marzoughi Michelle J. Chen Scott Jarvis* * MD at time of publication Nociceptors (nerve endings detecting pain) on skin become activated ↑ Cytokine & nerve growth factor release Primary afferent (sensory) neurons release ↑ levels of inflammatory neuropeptides Peripheral sensitization (threshold at which a nerve transmits a signal is lowered so that it more readily transmits signals) Widespread neurogenic inflammation (inflammation due to activation of peripheral nerve fibres) Sustained and dysregulated pro-inflammatory state Hyperalgesia (↑ sensitivity to feeling pain) Sweat gland related changes: Edema, sweating changes, asymmetric sweating Allodynia (pain from a stimulus that doesn’t normally cause pain) Trophic changes (wasting of skin, muscle, tissues; thinning of bones; thickening/thinning of nails) Motor dysfunction ↓ Range of motion Immobile due to severity of pain Impaired vasodilation & vasoconstriction Temperature asymmetry Altered skin color (red, blue, pale) Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Oct 28, 2024 on www.thecalgaryguide.com