Cutaneous sensory abnormalities in children and adolescents with complex regional pain syndromes
Cutaneous sensory abnormalities in children and adolescents with complex regional pain syndromes
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DOI：
10.1016/j.pain.2006.12.028
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发表时间：
2007-09-01
期刊：
影响因子：
7.4
通讯作者：
Berde, Charles B.
中科院分区：
文献类型：
--
作者：
Sethna, Navil F.;Meier, Petra M.;Berde, Charles B.
复杂区域疼痛综合征（CRPS）在儿童中的发病率越来越高。这些疾病似乎与成人中观察到的疾病明显不同。国际疼痛研究协会 CRPS 诊断标准是根据成人研究制定的；这些标准尚未针对儿童进行验证。我们对一组儿科患者进行了标准化神经学检查和定量感觉测试（QST），以表征感觉功能障碍的特征。四十二名病人。单侧下肢 CRPS 的疼痛和症状平均持续时间为 12.6 个月，符合 IASP 成人 CRPS 标准，接受标准化神经系统检查和 QST。将 QST 参数与先前从年龄和性别匹配的儿科健康对照中得出的值进行比较。在大多数方面，除了冷痛和热痛检测阈值之外，患者之间的 QST 参数与正常参考值没有显着差异。 21 名患者出现冷和/或热异常性疼痛 (P < 0.001)。冷异常性疼痛是我们患者中最常见的 QST 异常。 26 名患者表现出机械动态和静态异常性疼痛以及点状时间总和的异常性疼痛的组合。机械动力异常性疼痛与点状时间总和异常性疼痛之间存在显着相关性（P < 0.001）。与成人 CRPS 一样，热和机械感觉异常在具有相似临床表现的不同患者中以不同的组合出现。在大多数患者中，疼痛的发病机制似乎是核心原因。 (C) 2007 年国际疼痛研究协会。由 Elsevier B.V. 出版。保留所有权利。
Complex regional pain syndromes (CRPS) have been recognized with increasing frequency in children. These disorders appear to differ markedly from those observed in adults. The International Association for the Study of Pain diagnostic criteria for CRPS were developed based on adult studies; these criteria have not been validated for children. We performed standardized neurological examination and quantitative sensory testing (QST) in a group of pediatric patients to characterize features of sensory dysfunction. Forty-two patients. with unilateral lower extremity CRPS of a mean duration of the pain and symptoms of 12.6 months, who met IASP adult-based criteria for CRPS underwent standardized neurological examination and QST. QST parameters were compared to values previously derived from age- and sex-matched pediatric healthy controls. In most respects, QST parameters did not differ significantly between patients and the normal reference values except for cold and heat pain detection thresholds. Allodynia to cold and/or heat (P < 0.001) occurred in 21 patients. Cold allodynia was the most common QST abnormality in our patients. Twenty-six patients showed a combination of mechanical dynamic and static allodynia and allodynia to punctate temporal summation. There was a sianificant correlation between mechanical dynamic allodynia and allodynia to punctate temporal summation (P < 0.001). As with adult CRPS, the thermal and mechanical sensory abnormalities appear in different combinations in different patients with similar clinical presentations. In a majority of patients, the pathogenesis of pain is seemingly of central origin. (C) 2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.