PDF herunterladen
Handchir Mikrochir Plast Chir 2010; 42(1): 2-7
DOI: 10.1055/s-0030-1247521
Übersichtsarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Geschichte, Stadieneinteilung und Klinik des komplexen regionalen Schmerzsyndroms (CRPS)

History, Classification and Clinic of the Complex Regional Pain Syndrome (CRPS)H. Troeger1 , P. Hasenböhler1
  • 1Bethesda-Spital Basel, Klinik für Hand- und periphere Nervenchirurgie, Schweiz
Weitere Informationen

Publikationsverlauf

eingereicht 29.09.2009

akzeptiert 07.1.2010

Publikationsdatum:
04. März 2010 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Zusammenfassung

Fast 150 Jahre sind seit der Beschreibung der klassischen Symptome dessen, was heute unter dem Begriff CRPS zusammengefasst wird, vergangen. Aus einer Vielzahl von Bezeichnungen hat man sich 1986 auf diesen Terminus geeinigt und auch die damit in Zusammenhang stehenden Begriffe genauer definiert. In der Pathophysiologie dieses Symptomenkomplexes wird heute das Zusammenwirken von entzündlichen, vegetativen und zentral-nervösen Abläufen in unterschiedlicher Ausprägung und Gewichtung als Schlüsselstellung akzeptiert. Dabei gibt es zur Epidemiologie und Häufigkeit kaum neue Erkenntnisse. Im Gegensatz dazu haben verfeinerte Untersuchungsmethoden eine Reihe von Befunden erbracht, die die Zusammenhänge in einem neuen Licht erscheinen lassen und neue Therapieoptionen eröffnen.

Abstract

Almost 150 years are gone since the first description of the classic symptoms, what is today summarized under the term CRPS. From a big number of different names, it has been agreed in 1986 to this term and has also defined more exactly the corresponding terms to it. In the pathophysiology of this complex of symptomes is today accepted that it is a combination of inflammatory, vegetative and central-nervous processes in different size and weigth as a key position. There are hardly new findings in epidemiology and frequency. In opposite to this a number of results are produced by better methods for examination which let appear the connections in a new view and make new therapy options possible.

Schlüsselwörter

CRPS - komplexes regionales Schmerzsyndrom - Klassifikation - Komplikationen

Key words

CRPS - complex regional pain syndrome - classification - complications

Literatur

  • 1 Lau FH, Chung KC, Silas Weir Mitchell MD. The physician who discovered causalgia.  J.Hand Surg A. 29;  2004 181-187
    Google Scholar
  • 2 Mitchell SW, Morehouse GR, Keen WW. Gunshot wounds and other injuries of nerves.  Philadelphia. 1864; 
    Google Scholar
  • 3 Sudeck P. Über die acute (trophoneurotische) Knochenatrophie nach Entzündungen und Traumen der Extremitäten.  Dtsch med Wschr. 28;  1902 336-342
    Google Scholar
  • 4 Leriche R. De la causalgie envisagée comme une névrite du sympathetique et de son traitement par la dénudation et lŽexcision des plexus nerveux péri-artériels.  Presse Med. 24;  1916 178-180
    Google Scholar
  • 5 Beerthuizen A, Spijker AVT, Huygen FJPM. et al . Is there an association between psychological factors and the Complex Regional Pain Syndrom type 1 (CRPS1) in adults? A systematic review.  Pain. 145;  2009 52-59
    Google Scholar
  • 6 Evans JA. Reflex sympathetic dystrophy: report on 57 cases.  Ann Intern Med. 26;  1947 417-426
    Google Scholar
  • 7 Richards RL. Causalgia: A centennial review.  Arch Neurol. 16;  1967 339-350
    Google Scholar
  • 8 International Association for the study of pain. . Sot Pain Suppl. 1986 3
    Google Scholar
  • 9 Broggi G. Pain and psycho-affective disorders.  Neurosurgery. 62;  2008 901-919
    Google Scholar
  • 10 Loeser JD, Treede RD. The Kyoto protocol of IASP Basic Pain Terminology.  Pain. 137;  2008 473-477
    Google Scholar
  • 11 ▪. Therapierichtlinie der Deutschen Gesellschaft für Physikalische Medizin und Rehabilitation – Behandlung beim komplexen regionalen Schmerzsyndrom (sympathische Reflexdystrophie).  Phys Med Rehab Kuror. 12;  2002 208-210
    Google Scholar
  • 12 Heierli P, Meyer J-L, Radziwill A. Nosologischer Rahmen und Terminologie.. In: (Ed.) Algodystrophie. SUVA & NOVARTIS 1998: S5-S9
    Google Scholar
  • 13 Geusens P, Santen MV. Algodystrophy.  Baillière's Clinical Rheumatology. 2000;  14 499-513
    Google Scholar
  • 14 Baron R, Binder A, Ulrich W. et al . Komplexe regionale Schmerzsyndrome.  Nervenarzt. 2002;  73 305-320
    Google Scholar
  • 15 Baron R, Jänig W. Schmerzsyndrome mit kausaler Beteiligung des Sympathikus.  Anaesthesist. 1998;  47 4-23
    Google Scholar
  • 16 Kedra AW, Kutarski A. Shoulder-hand algodystrophic syndrome in patients following myocardial infarct.  Pol Tyg Lek. 1977;  32 67-68
    Google Scholar
  • 17 Maihöfner C, Birklein F. Komplex regionale Schmerzsyndrome: Neues zur Pathophysiologie und Therapie.  Forschr Neurol Psychiat. 2007;  75 331-342
    Google Scholar
  • 18 Eberle T, Doganci B, Kramer HH. et al . Warm and cold complex regional pain syndromes: differences beyond skin temperature?.  Neurology. 2009;  72 505-512
    Google Scholar
  • 19 Raja SN, Grabow TS. Complex regional pain syndrome I (Reflex sympathetic dystrophy).  Anesthesiology. 2002;  96 1254-1260
    Google Scholar
  • 20 Baron R, Maier C. Reflex sympathetic dystrophy: Skin blood flow, sympathetic vasoconstrictor reflexes and pain before and after surgical sympathectomy.  Pain. 1996;  67 317-326
    Google Scholar
  • 21 Birklein F, Weber M, Neundörfer B. Increased skin lactate in complex regional pain syndrom: Evidence for tissue hypoxia?.  Neurology. 2000;  55 1213-1215
    Google Scholar
  • 22 Ide J, Yamaga M, Kitamura T. et al . Quantitative evaluation of sympathetic nervous system dysfunction in patients with reflex sympathetic dystrophy.  J Hand Surg. 1997;  22B 102-106
    Google Scholar
  • 23 Pollock Jr FE, Koman LA, Smith BP. et al . Patterns of microvascular response associated with reflex sympathetic dystrophy of the hand and wrist.  J Hand Surg. 1993;  18A 847-852
    Google Scholar
  • 24 Rothkirch TV, Blauth W, Helbig B. Das Sudeck-Syndrom der Hand.  Handchir Mikrochir Plast Chir. 1989;  21 115-126
    Google Scholar
  • 25 Wasner G, Schattschneider J, Binder A. et al . Complex regional pain syndrome – diagnostic, mechanisms, CNS involvement and therapy.  Spinal Cord. 2003;  41 61-75
    Google Scholar
  • 26 Marshall AT, Crisp AJ. Reflex sympathetic dystrophy.  Rheumatology. 2000;  39 692-695
    Google Scholar
  • 27 Pucevich B, Spencer L, English JC. Unilateral trachyonychia in a patient with reflex sympathetic dystrophy.  J Am Acad Dermatol. 2008;  58 320-322
    Google Scholar
  • 28 Birklein F, Riedl B, Griesinger N. et al . Komplexes regionales Schmerzsyndrom.  Nervenarzt. 1999;  70 335-341
    Google Scholar
  • 29 Schwartzmann RJ. New treatments for reflex sympathetic dystrophy.  N Engl J Med. 343;  2000 654-656
    Google Scholar
  • 30 Hilten BJV, Beek W-JTV, Hoff JI. et al . Intrathecal baclofen for the treatment of dystonia in patients with reflex sympathetic dystrophy.  N Engl J Med. 343;  2000 625-630
    Google Scholar
  • 31 Bruehl S, Harden RN, Galer BS. et al . Complex regional pain syndrome: are there distinct subtypes and sequential stages of the syndrome?.  Pain. 2002;  95 119-124
    Google Scholar
  • 32 Goris RJA, Laan LVD. Reflex sympathetic dystrophy – another view.  Europ J Trauma. 2001;  99-103
    Google Scholar
  • 33 Mos MD, Huygen FJPM, Hoeven-Borgmann MVD. et al . Outcome of the Complex Regional Pain Syndrome.  Clin J Pain. 2009;  25 590-597
    Google Scholar
  • 34 Sandroni P, Benrud-Larson LM, McClelland RL. et al . Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a population-based study.  Pain. 2003;  103 199-207
    Google Scholar
  • 35 deMos M, deBruijn AG, Huygen FJ. et al . The incidence of complex regional pain syndrome: a population-based study.  Pain. 2007;  129 12-20
    Google Scholar
  • 36 Beck RW. Conservative therapy for Complex Regional Pain Syndrome Type I in a paediatric patient: a case study.  JCCA J Can Chiropr Assoc. 2009;  53 95-101
    Google Scholar
  • 37 Bernstein BH, Singsen BH, Kent JT. et al . Reflex neurovascular dystrophy in childhood.  J Pediatr. 1978;  93 211-215
    Google Scholar
  • 38 Betend B, Lebacq E, Kohler R. et al . Metaphyseal osteolysis. Unusual aspect of reflex algodystrophy in children (author's transl).  Arch Fr Pediatr. 1981;  38 121-123
    Google Scholar
  • 39 Cazeneuve JF, Leborgne JM, Kermad K. et al . Vitamin C and prevention of reflex sympathetic dystrophy following surgical management of distal radius fractures.  Acta Orthop Belg. 2002;  68 481-484
    Google Scholar
  • 40 Dadure C, Motais F, Ricard C. et al . Continuous peripheral nerve blocks at home for treatment of recurrent complex regional pain syndrome I in children.  Anesthesiology. 2005;  102 387-391
    Google Scholar
  • 41 Fermaglich DR. Reflex sympathetic dystrophy in children.  Pediatrics. 1977;  60 881-883
    Google Scholar
  • 42 Guler-Uysal F, Basaran S, Geertzen JH. et al. . A 2œ-year-old girl with reflex sympathetic dystrophy syndrome (CRPS type I): case report.  Clin Rehabil. 2003;  17 224-227
    Google Scholar
  • 43 Low AK, Ward K, Wines AP. Pediatric complex regional pain syndrome.  J Pediatr Orthop. 2007;  27 567-572
    Google Scholar
  • 44 Small NC. Complications in arthroscopic surgery performed by experienced arthroscopists.  Arthroscopy. 1988;  4 215-221
    Google Scholar
  • 45 Troeger H. Algodystrophie.. In: Krupp S ,(Ed.) Plastische Chirurgie. 22. Erg. Lfg. ECOMED, Landsberg 2003: S1-S12
    Google Scholar
  • 46 Rooij AMD, deMos M, Sturkenboom MC. et al . Familial occurence of complex regional pain syndrome.  EurJ Pain. 2009;  13 171-177
    Google Scholar
  • 47 Helms CA, O’Brien ET, Katzberg RW. Segmental reflex sympathetic dystrophy syndrome.  Radiology. 1980;  135 67-68
    Google Scholar
  • 48 Kline SC, Holder LA. Segmental Reflex Sympathetic Dystrophy: Clinical and Scintigraphic Criteria.  J Hand Surg A. 1993;  18 853-859
    Google Scholar
  • 49 Duman I, Dincer U, Taskaynatan MA. et al . Reflex sympathetic dystrophy: a retrospective epidemiological study of 168 patients.  Clin Rheumatol. 2007;  26 1433-1437
    Google Scholar
  • 50 Houdenhove BV, Vervaeke G, Onghena P. et al . Psychometric characteristics of 66 patients with reflex sympathetic dystrophy.  Eur J Pain. 1994;  15 50-58
    Google Scholar
  • 51 Feldman SI, Downey G, Schaffer-Neitz R. Pain, negative mood and perceived support in chronic pain patients: a daily diary study of people with reflex sympathetic dystrophy syndrome.  J Consult Clin Psychol. 1999;  67 776-785
    Google Scholar
  • 52 Bircher J, Schieweck C, Schenk R. 77 Studies on the experimental induction of Sudeck's dystrophy and its prevention.  Langenbecks Arch Chir. 1967;  319 454-457 454–457
    Google Scholar
  • 53 Bircher JL. Schmerzsyndrome.. In: , (Ed.) Handchirurgie 1. Thieme, Stuttgart – New York. 1981: Kap. 21
    Google Scholar
  • 54 Guo TZ, Wei T, Kingery WS. Glucocorticoid inhibition of vascular abnormalities in a tibia fracture rat model of complex regional pain syndrome type I.  Pain. 2006;  121 158-167
    Google Scholar
  • 55 Kingery WS, Davies MF, Clark JD. A substance P receptor (NK1) antagonist can reverse vascular and nociceptive abnormalities in a rat model of complex regional pain syndrome type II.  Pain. 2003;  104 75-84
    Google Scholar
  • 56 Sabsovich I, Wei T, Guo TZ. et al . Effect of anti-NGF antibodies in a rat tibia fracture model of complex regional pain syndrome type I.  Pain. 2008;  138 47-60
    Google Scholar
  • 57 Dayan L, Salman S, Norman D. et al . Exaggerated vasoconstriction in complex regional pain syndrome-1 is associated with impaired resistance artery endothelial function and local vascular reflexes.  J Rheumatol. 2008;  35 1339-1345
    Google Scholar
  • 58 Groeneweg JG, Antonissen CH, Huygen FJ. et al . Expression of endothelial nitric oxide synthase and endothelin-1 in skin tissue from amputated limbs of patients with complex regional pain syndrome.  Mediators Inflamm. 2008;  680-981
    Google Scholar
  • 59 Birklein F, Schmelz M. Neuropeptides, neurogenic inflammation and complex regional pain syndrome (CRPS).  Neurosci Lett. 2008;  437 199-202
    Google Scholar
  • 60 Birklein F, Schmelz M, Schifter S. et al . The important role of neuropeptides in complex regional pain syndrome.  Neurology. 2001;  57 2179-2184
    Google Scholar
  • 61 Mos MD, Huygen FJ, Van DH-B. et al . Sturkenboom MC Referral and treatment patterns for complex regional pain syndrome in the Netherlands.  Acta Anaesthesiol Scand. 2009;  53 816-825
    Google Scholar
  • 62 Wasner G, Schattschneider J, Binder A. et al . Recent trends in understanding and therapy of complex regional pain syndromes.  Anaesthesist. 2003;  52 883-895
    Google Scholar
  • 63 Weber M, Birklein F, Neundorfer B. et al . Facilitated neurogenic inflammation in complex regional pain syndrome.  Pain. 2001;  91 251-257
    Google Scholar
  • 64 Vaneker M, Laan Lvd, Allebes W. et al . Genetic factors associated with complex regional pain syndrom 1: HLA DRB and TNF-alpha promoter gene polymorphism.  Disabil Med. 2002;  2 69-74
    Google Scholar
  • 65 Kemler MA, Vusse ACVD, Berg-Loonen EMVd. et al . HLA-DQ1 associated with reflex sympathetic dystrophy.  Neurology. 53;  53x 1350-1351
    Google Scholar
  • 66 Swart KCM, Stins JF, Beek PJ. Cortical changes in complex regional pain syndrome (CRPS).  Eur J Pain. 2008; 
    Google Scholar
  • 67 Maihöfner C, Handwerker HO, Neundorfer B. et al . Patterns of cortical reorganization in complex regional pain syndrome.  Neurology. 2003;  61 1707-1715
    Google Scholar
  • 68 Moseley GL. Graded motor imagery for pathologic pain: a randomized controlled trial.  Neurology. 2006;  67 2129-2134
    Google Scholar
  • 69 Vartiainen N, Kirveskari E, Kallio-Laine K. et al . Cortical reorganization in primary somatosensory cortex in patients with unilateral chronic pain.  J Pain. 2009;  10 854-859
    Google Scholar
  • 70 Weber M, Neundorfer B, Birklein F. Sudeck's Atrophie: Pathophysiologie und Behandlung des komplexen Schmerzsyndroms.  Dtsch Med Wochenschr. 2002;  127 384-389
    Google Scholar
  • 71 Peterlin BL, Rosso AL, Nair S. et al . Migraine may be a risk factor for the development of complex regional pain syndrome.  Cephalalgia. 2009; 
    Google Scholar
  • 72 Toda K, Muneshige H, Maruishi M. et al . Headache may be a risk factor for complex regional pain syndrome.  Clin Rheumatol. 2006;  25 728-730
    Google Scholar
  • 73 Wei T, Sabsovich I, Guo TZ. et al . Pentoxifylline attenuates nociceptive sensitization and cytokine expression in a tibia fracture rat model of complex regional pain syndrome.  Eur J Pain. 2009;  13 253-262
    Google Scholar
  • 74 Wesseldijk F, Fekkes D, Huygen FJ. et al . Increased plasma serotonin in complex regional pain syndrome type 1.  Anesth Analg. 2008;  106 1862-1867
    Google Scholar
  • 75 Schinkel C, Scherens A, Koller M. et al . Systemic inflammatory mediators in post-traumatic complex regional pain syndrome (CRPS I) – longitudinal investigations and differences to control groups.  Eur J Med Res. 2009;  14 130-135
    Google Scholar
  • 76 Munts AG, Zijlstra FJ, Nibbering PH. et al . Analysis of cerebrospinal fluid inflammatory mediators in chronic complex regional pain syndrome related dystonia.  Clin J Pain. 2008;  24 30-34
    Google Scholar
  • 77 Tan EC, de Keijzer MH, Goris RJ. Capillary blood gas analysis in complex regional pain syndrome: a pilot study.  Ann Clin Biochem. 2003;  40 569-571
    Google Scholar
  • 78 Koban M, Leis S, Schultze-Mosgau S. et al . Tissue hypoxia in complex regional pain syndrome.  Pain. 2003;  104 149-157
    Google Scholar
  • 79 Nishikawa M, Tanioka M, Araki E. et al . Extensive skin necrosis of the arm in a patient with complex regional pain syndrome.  Clin Exp Dermatol. 2008;  33 733-735
    Google Scholar
  • 80 Mos MD, Huygen FJ, Stricker BH. et al . Estrogens and the risk of complex regional pain syndrome (CRPS).  Pharmacoepidemiol Drug Saf. 2009;  18 44-52
    Google Scholar
  • 81 Beckmann J, Kock F, Grifka J. et al . CRPS Typ I – ein psychologischer Grundlagenbericht.  Z Rheumatol. 2005;  64 581-585
    Google Scholar
  • 82 Blake H. Strain and psychological distress among informal supporters of reflex sympathetic dystrophy patients.  Disabil Rehabil. 2000;  22 827-832
    Google Scholar
  • 83 Field J, Gardner FV. Psychological distress associated with algodystrophy.  J Hand Surg A. 1997;  22 100-101
    Google Scholar
  • 84 Lynch ME. Psychological aspects of reflex sympathetic dystrophy: a review of the adult and pediatric literature.  Pain. 1992;  49 337-347
    Google Scholar
  • 85 Houdenhove BV, Vasquez G, Onghena P. et al . Etiopathogenesis of reflex sympathetic dystrophy: A review and biopsychosocial hypothesis.  The Clinical Journal of Pain. 1992;  8 300-306
    Google Scholar
  • 86 Petersen GK, Jensen MR, Dahlin LB. et al . Reflex dystrophy. Complex regional pain syndrome type I.  Ugeskr Laeger. 2002;  164 5019-5024
    Google Scholar

Korrespondenzadresse

Prof. Hans Troeger

Bethesda-Spital

Klinik für Hand-und periphere

Nervenchirurgie

Gellertstr. 144

4052 Basel

Schweiz

eMail: troegerh@econophone.ch

      >