Complex regional pain syndrome

  title={Complex regional pain syndrome},
  author={Frank Birklein},
  journal={Journal of Neurology},
  • F. Birklein
  • Published 1 February 2005
  • Medicine, Psychology, Biology
  • Journal of Neurology
Complex regional pain syndrome (CRPS) may develop after limb trauma and is characterized by pain, sensory-motor and autonomic symptoms. Most important for the understanding of the pathophysiology of CRPS are recent results of neurophysiological research. Major mechanism for CRPS symptoms, which might be present subsequently or in parallel during the course of CRPS, are trauma-related cytokine release, exaggerated neurogenic inflammation, sympathetically maintained pain and cortical… 
Complex Regional Pain Syndrome (CRPS): Type I and Type II
Complex regional pain syndrome (CRPS) is a disorder that describes a variety of chronic pain states and is usually focal and distal and accompanied by central dysfunction and sensitization.
Complex regional pain syndrome is characterised by extreme pain and dysfunction of the sympathetic nervous system in one region of the body, usually an extremity and is multifaceted manifesting both central and peripheral neurologic pathophysiology, including a prominent psychosocial component.
Adult Complex Regional Pain Syndrome Type I: A Narrative Review
Chronic Regional Pain Syndrome
Treatment should be started as soon as possible using a multidisciplinary approach including physical therapy, psychological therapy, topical or oral medications, and/or procedural interventions for severe cases.
Systemic Complications of Complex Regional Pain Syndrome
How CRPS affects the systems of: cognition; constitutional, cardiac, and respiratory complications; systemic autonomic dysregulation; neurogenic edema; musculoskeletal, endocrine and dermatological manifestations; as well as urological and gastrointestinal function is examined.
Complex Regional Pain Syndrome: State of the Art Update
Although the pathophysiology of complex regional pain syndrome (CRPS) is not fully understood, recent work suggests that bisphosphonates may be useful in CRPS management and that the N-methyl-d-aspartate receptor antagonist ketamine significantly reduces CRPS pain when administered topically or intravenously at subanesthetic dosages.
Complex regional pain syndrome: a recent update
The aim of this review is to report on the recent progress in the understanding of the epidemiology, pathophysiology and treatment of CRPS and to discuss novel approaches in treating this condition.
REVIEW ARTICLE Current Understandings on Complex Regional Pain Syndrome
An overview of the current under- standings regarding pathology of the autonomic and somatic nervous system in CRPS, as well as the roles of neurogenic inflammation, hypoxia, and the contribution of psychological factors is provided.
Spontaneous onset of Complex Regional Pain Syndrome


Evidence for local inflammation in complex regional pain syndrome type 1.
This is the first time that involvement of mediators of inflammation in CRPS 1 has been so clearly and directly demonstrated and opens new approaches for the succesful use and development of immunosuppressives inCRPS 1.
Autonomic failure after stroke – is it indicative for pathophysiology of complex regional pain syndrome?
It is suggested that many clinical symptoms and the main features of sympathetic dysfunction in CRPS could be explained by a CNS pathophysiology.
Neglect-like symptoms in complex regional pain syndrome: results of a self-administered survey.
Bilateral motor cortex disinhibition in complex regional pain syndrome (CRPS) type I of the hand
A bilateral disinhibition of the motor cortex in patients with complex regional pain syndrome is shown, showing a significant reduction of intracortical inhibition on both sides of patients with CRPS compared with control subjects.
The important role of neuropeptides in complex regional pain syndrome
Increased systemic CGRP levels in patients with acute CRPS suggest neurogenic inflammation as a pathophysiologic mechanism contributing to vasodilation, edema, and increased sweating, however, pain and hyperalgesia, in particular in chronic stages, were independent of increased neuropeptide concentration.
The motor system shows adaptive changes in complex regional pain syndrome.
The results of this study suggest that substantial adaptive changes within the central nervous system may contribute to motor symptoms in CRPS.
Cortical reorganization during recovery from complex regional pain syndrome
Changes of the somatotopic map within the S1 cortex may depend on CRPS pain and its recovery, and these changes are unclear how these S1 changes develop following successful therapy.
Multifocal or generalized tonic dystonia of complex regional pain syndrome: A distinct clinical entity associated with HLA‐DR13
HLA‐DR13 may be a factor indicating susceptibility to this distinct phenotype of complex regional pain syndrome, which initiated distally, involved mainly flexor muscles, and was associated with sensory and autonomic symptoms.