Abstract:
Background and Objectives: One of the most challenging tasks in a clinical setting is to differentiate between complex regional pain syndrome (CRPS) type II and traumatic neuropathic pain (NeP). CRPS is characterized by several dysautonomic manifestations, such as edema, hyper/hypohidrosis, skin color change, and tachycardia. This study compared the outcomes of autonomic function screening tests in patients with CRPS type II and traumatic NeP for diagnostic differentiation. Materials and Methods: CRPS type II was diagnosed according to the Budapest research criteria, while NeP was diagnosed according to the updated grading system suggested by the International Association for the Study of Pain Special Interest Group on Neuropathic Pain in 2016. Twenty patients with CRPS type II and twenty-five with traumatic NeP were investigated. Results: Twelve patients with CRPS type II presented abnormal results for the quantitative sudomotor axon reflex test (QSART). Abnormal QSART results were more common in the CRPS type II group. Conclusions: Analysis of QSART combined with other ancillary tests can help in the differential diagnosis of CRPS type II and traumatic NeP if factors influencing abnormal QSART are sufficiently controlled.
摘要:
背景和目的:临床环境中最具挑战性的任务之一是区分复杂区域疼痛综合征(CRPS)II型和创伤性神经性疼痛(NeP)。CRPS的特征是几种自主神经失调表现,如水肿,多汗症,皮肤颜色变化,和心动过速.这项研究比较了CRPSII型和创伤性NeP患者的自主神经功能筛查试验的结果,以进行诊断鉴别。材料和方法:CRPSII型根据布达佩斯研究标准诊断,而NeP是根据2016年国际疼痛研究协会神经性疼痛特别兴趣小组建议的更新分级系统诊断的。调查了20例II型CRPS患者和25例创伤性NeP患者。结果:12例II型CRPS患者的定量sudomotor轴突反射试验(QSART)结果异常。异常QSART结果在CRPSII型组中更常见。结论:如果影响QSART异常的因素得到充分控制,QSART的分析结合其他辅助检查可有助于CRPSII型和创伤性NeP的鉴别诊断。