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RSD Article # 12

The following article was published in the book Clinical Aspects of Reflex Sympathetic Dystrophy, written by Dr. Peter Veldmand from the Department of Surgery, University Hospital Nijmegen, The Netherlands.

Below is an abstract from Chapter 7 from the book Clinical Aspects of Reflex Sympathetic Dystrophy.

Please click on the link below to view the full text of this article in PDF-format.

RSD Article #12

 

chapter
7

REFLEX SYMPATHETIC DYSTROPHY
CAUSED BY NERVE INJURY?
Electromyography in 75 patients


Peter H.J.M. Veldman, M.D. *
Dick M. Vingerhoets, M.D. **
R. Jan A. Goris M.D., Ph.D. *



* Department of Surgery, University Hospital Nijmegen, The Netherlands
* * Department of Clinical Neurophysiology University Hospital Nijmegen, The Netherlands

ABSTRACT

Reflex sympathetic dystrophy (RSD) has been considered as a pathological process developing after nerve trauma. 75 patients with RSD and neurologic signs and symptoms were investigated with EMG. In 40 patients, no disturbances were found. In 7 patients minor disturbances were present. In 28 patients, results indicated a compression neuropathy (11 x), a nerve injury the luxating event of RSD (8) or other coexistent pathology. For patients with disturbances found on EMG, the results of EMG could never offer an explanation for all neurologic signs and symptoms present. As both clinical signs and symptoms and EMG findings can not be attributed to nerve trauma, we do not support the concept of a - mechanical - nerve injury as the universal cause of RSD. A locally produced toxic factor which damages all structures seems more probable. In this latter concept, etiologic events, character and distribution of the signs and symptoms in RSD can all be explained. Decreased specialized sensory functions can be attributed to damage of receptors, increased pain sensation to sensitized nociceptors and effects of sympathetic blockade to a-adrenergic sensitization. Toxic oxygen radicals produced in an inflammatory (re) action to trauma or surgery are a possible cause.

Peter H.J.M. Veldman, M.D., et, al. Reflex Sympathetic Dystrophy Caused By Nerve Injury? : Electomyography in 75 Patients. Thesis- Clinical Aspects of Reflex Sympathetic Dystrophy, Chapter 7: 87-96