Reflex neurovascular dystrophy

Since 1984, altogether nine cases of otherwise untreatable reflex sympathetic dystrophy (RSD) of the upper extremity were treated by transaxillary decompression of the neurovascular bundle with resection of the upper thoracic ganglia. This resulted in an immediate improvement of the local findings and the entire post-operative course of treatment as well as significantly improved functional results (seven excellent, one good, one fair). Average follow-up was 7.5 years. All patients returned to their original work...

This article has discussed the peripheral and central mechanisms of the various orofacial pain conditions, including musculoskeletal disorders, neurogenic inflammation, and neuropathic pain. To make an accurate diagnosis of orofacial pain and render treatment, all organ systems need to be considered and evaluated. Central sensitization was discussed as it relates to musculoskeletal disorders and neuropathic pain. It has been suggested that treatment of these disorders be problem oriented, addressing both peripheral and central mechanisms if present...

Ankle arthroscopy has grown in popularity over the past decade as a diagnostic and therapeutic procedure. We assessed 24 patients who underwent ankle arthroscopy during the two year period 1991-1993. In 18 cases a mini-arthrotomy was performed based on the arthroscopic findings. All patients were reviewed at an average of 26 months and a detailed evaluation was carried out according to an objective scoring system which grades five parameters; pain, swelling, stiffness, limp, and activity level. Twenty-two patients (92%) had good or excellent results...

This single-group prospective cohort study was conducted to define the efficacy and safety of single-portal endoscopic carpal tunnel release using the redesigned carpal tunnel release system (3M Healthcare, St Paul, MN). Eighty-six procedures in 69 patients were evaluated by objective motor/sensory testing and clinical outcome questionnaire at 10 days, and 6 and 10 weeks postoperatively. All cases were performed by the same surgeon using a similar local anesthetic technique. The subjective symptoms of carpal tunnel syndrome, including paresthesia, numbness, and pain, demonstrated substantial improvement by 10 days postoperatively, and less than 2% of the subjects remained symptomatic by 10 weeks...

BACKGROUND AND OBJECTIVES: The present study was performed at the Crystal Clinic Surgery Center, an outpatient free-standing surgicenter specializing in orthopedic surgery, to determine the incidence of both neurologic and vascular sequelae associated with exclusive use of a transarterial approach to axillary brachial plexus block in order to assess the technique's safety and efficacy. METHODS: The prospective consecutive study involved 1,000 adult patients scheduled for surgery using axillary brachial plexus block...

Two children 7 and 14 years old respectively, presented with reflex neurovascular dystrophy. The salient feature of the disease consisted of osteolytic lesions of distal tibial and fibulal metaphyses. To out knowledge these were not previously reported. Complete recovery spontaneously occurred in a few weeks or months. Thus they do not require any treatment, which might be harmful.

The author summarizes the data of his long-term studies concerning one of the areas of neuroangiology: the problem of neurovascular syndromes. The latter ones can be identified as symptom-complexes of combined affections of the nervous and vascular systems associated with the compression and reflex mechanisms. Involved in their genesis are vertebral pathologies and anomalies, atherosclerosis of the major vessels, tonic and dystrophic changes of the muscles, etc. The report presents the first attempt at a classification of neurovascular syndromes and their detailed semiologic characteristics...

No abstract text is available yet for this article.

Sudeck's atrophy, initiated by local irritation, proceeds from a mild form of neurovascular and osseous changes to a stage of increasing or intractable pain and trophic changes. Differential diagnosis is important as a number of conditions may produce a similar clinical picture. At any stage, the disease may improve spontaneously or from therapy, or it may result in varying degrees of permanent disability.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

A child suffering from reflex neurovascular dystrophy (RND) who presented with a bizarre neurological picture is reported. RND is an extremely painful and disabling condition readily amenable to treatment. A striking feature is the localisation of pain and hyperaesthesia which do not follow a somatic dermatome distribution.

Six children with reflex neurovascular dystrophy are described. The clinical characteristics are discussed, and the contrasting features between the adult and childhood syndrome are considered. The importance of early diagnosis and appropriate therapy is stressed.

The authors report on 4 cases of particularly severe and extensive reflex neurovascular dystrophy, whose clinical course was marked by the onset of a malignant tumor, without any sign of improvement in the reflex neurovascular dystrophy, despite various therapeutic regimens, until the patient's death from malignancy. At this time, the authors compiled a total of 63 case reports (4 of which were reported) and have proposed a classification to differentiate 4 types of disorders in combination according to whether there is a very probable, probable, or possible link or whether the combination is strictly a coincidence...

Psychosocial factors in 21 families with children affected by reflex neurovascular dystrophy were studied. Each family was interviewed and given a battery of standardized psychologic tests. Two distinct types of families were identified. Fifteen families showed high internal cohesion, expressiveness, and organization and low levels of conflict. Six families showed high overt conflict with low levels of family cohesion, expressiveness, and organization. In all families parental enmeshment with the patient was present...

Eleven children with reflex neurovascular dystrophy were investigated by technetium-labeled methylene diphosphonate bone scanning. Eight of 12 scans demonstrated abnormal findings, four showing diffusely decreased uptake and four diffusely increased uptake of the radionuclide in the affected site. Three scans showed normal findings initially, as did one previously abnormal scan when repeated in the asymptomatic patient 6 months later. Diffusely abnormal findings can be helpful in the diagnosis of childhood reflex neurovascular dystrophy, but a normal scan does not exclude the diagnosis...

Reflex neurovascular dystrophy (RND) is less common in children than in adults, and differences in onset, clinical course, response to treatment, and degree of disability suggest a different pathogenesis. We have assessed the usefulness of nuclear imaging in 15 children with RND who were evaluated from March 1983 to September 1985. Abnormal findings on 3-phase bone scans were observed in 14 children, with diffusely decreased bone uptake at the symptomatic site being the most common observation. This contrasts sharply with previous reports of diffusely increased uptake in most adults with RND...

A 15-year-old girl complained of swelling and shooting pains in the right upper extremity, which had bothered her for seven months. Physical examination revealed swelling, cyanosis, weakness and hyperesthesia over the entire right upper extremity. Serological and biochemical data were within normal limits. She was diagnosed as having reflex neurovascular dystrophy (RND). Psychological problems with school and her family might have contributed to the pathogenesis of the disease. With autogenic training (AT), remission was obtained within eighteen months...

Childhood disability and chronic disease are common, and their prevalence is increasing as children survive with conditions that were previously fatal. It is important that physicians in training learn about disability and handicap, and the functioning of multidisciplinary teams to manage these problems. Chronic ill-health is often very expensive to manage, and some serious and creative thinking about the best way to fund such health care is urgently needed. Pediatric rheumatologists are involved with the care of many children with chronic and recurrent musculoskeletal pain; however, they have not perhaps focused enough research effort on the investigation of pain and its management...