Severity and specificity of neglect-like symptoms in patients with complex regional pain syndrome (CRPS) compared to chronic limb pain of other origins
Severity and specificity of neglect-like symptoms in patients with complex regional pain syndrome (CRPS) compared to chronic limb pain of other origins
复制标题
DOI：
10.1016/j.pain.2006.04.010
复制
发表时间：
2006-09-01
期刊：
影响因子：
7.4
通讯作者：
Maier, Christoph
中科院分区：
文献类型：
--
作者：
Frettloeh, Jule;Hueppe, Michael;Maier, Christoph
在文献中，忽视样综合征被描述为CRPS的另一种现象。认为受影响的肢体是奇怪的、混乱的和不属于身体的感觉是这种综合征的典型和特征。由于这一现象在其他疼痛情况下从未被研究过，我们评估了上肢和下肢CRPS患者(n=123)和其他原因慢性肢体疼痛的对照组(n=117)忽视样症状的发生和程度。我们用于描述忽视样综合征的问卷包括Galer和Jensen[Galer BS，Jensen M.]之后的五个项目：复杂区域疼痛综合征的忽视样症状：自我管理调查的结果。疼痛和症状管理杂志1999；18：213-6]，用六分反应量表询问各自症状的程度。结果表明，CRPS患者和非CRPS肢体疼痛患者都表现出所谓的忽视样综合征。然而，CRPS组确诊此类症状的人数显著高于对照组(OR=2.87)，而且这些患者报告的症状更严重(F=17.74；P=0.001)。忽视样总分为>；=5时，诊断敏感性较低(21.1%)，但对CRPS的诊断特异性可达90.6%。本研究包括上肢和下肢CRPS患者。这两个地点之间关于疏忽样综合症的唯一区别是“不自主运动”的症状，这种症状明显更多地出现在受影响的腿上。总之，我们建议评估忽视样症状，并将其作为CRPS诊断的附加标准。>；=5的高分可确认CRPS的诊断，而低分不能用于疾病分类。(C)2006年国际疼痛研究协会。爱思唯尔出版，版权所有。
In the literature, the neglect-like syndrome is described as an additional phenomenon of CRPS. The perception of the affected limb as strange, disordered and not belonging to the body is typical of and characterises this syndrome. Since this phenomenon has never been studied in other pain conditions, we assessed occurrence and extent of neglect-like symptoms in patients with CRPS of the upper and lower limb (n = 123) and in a control group with chronic limb pain of other origins (n = 117). Our questionnaire for describing the neglect-like syndrome encompassed five items following Galer and Jensen [Galer BS, Jensen M. Neglect-like symptoms in complex regional pain syndrome: results of a self-administered survey. Journal of Pain and Symptom Management 1999;18:213-6], with a six-point response scale inquiring the extent of respective symptoms. Results show that CRPS-patients as well as patients with non-CRPS limb pain exhibit the so-called neglect-like syndrome. However, the number of patients confirming such symptoms was significantly higher (OR = 2.87) in the CRPS group, moreover, these patients reported more severe symptoms (F = 17.74; p = 0.001). If the neglect-like total score is >= 5, the diagnostic sensitivity is low (21.1%), but the specificity for the diagnosis of CRPS reaches 90.6%. In this study, patients with CRPS of the upper and lower limb were included. The only difference between these two localisations concerning the neglect-like syndrome was the symptom of 'involuntary movements', which occurs significantly more often in affected legs. In conclusion, we recommend to evaluate neglect-like symptoms and to use them as an additional criterion in the diagnosis of CRPS. High scores of >= 5 confirm the diagnosis of CRPS, whereas lower scores must not be used for disease classification. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.