Síndrome dolorosa complexa regional: epidemiologia, fisiopatologia, manifestações clínicas, testes diagnósticos e propostas terapêuticas

Francisco Carlos Obata Cordon; Lino Lemonica

doi:10.1590/S0034-70942002000500013

Review Article

Síndrome dolorosa complexa regional: epidemiologia, fisiopatologia, manifestações clínicas, testes diagnósticos e propostas terapêuticas

Complex regional pain syndrome: epidemiology, pathophysiology, clinical manifestations, diagnostic tests and therapeutic proposals

Francisco Carlos Obata Cordon; Lino Lemonica

http://dx.doi.org/10.1590/S0034-70942002000500013 Braz J Anesthesiol, vol.52, n5, p.618-627, 2002

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Resumo

JUSTIFICATIVA E OBJETIVOS: A Síndrome Dolorosa Complexa Regional (SDCR), assim denominada a partir de 1994 pelo Consenso da Associação Internacional para o Estudo da Dor (AIED) e anteriormente denominada de várias formas, tais como Distrofia Simpático Reflexa, Causalgia, Algodistrofia ou Atrofia de Sudeck, é uma doença cuja compreensão dos limites clínicos, fisiopatologia e implicações de patogenia ainda é pobre. Disto resulta a enorme insatisfação não só para os pacientes como para os profissionais da saúde quanto aos métodos terapêuticos atualmente disponíveis. O objetivo deste trabalho é rever a literatura e atualizar um conjunto de informações com o intuito da melhor compreensão desta importante síndrome dolorosa. CONTEÚDO: Este é um trabalho de revisão da literatura nos diversos aspectos da SDCR, com ênfase em suas causas, definição e taxonomia, fisiopatologia, características clínicas, testes diagnósticos e propostas de tratamentos mais recentes. CONCLUSÕES: Poucos são os estudos controlados adequadamente, encobertos e aleatórios, publicados com grandes amostras, havendo muitas dúvidas sobre esta doença. Desta forma, ainda há enorme empirismo na sua terapêutica, e os resultados obtidos são insatisfatórios.

Palavras-chave

DOR, DOR

Abstract

BACKGROUND AND OBJECTIVES: The term Complex Regional Pain Syndrome (CRPS) was adopted as from 1994 by the International Association for Study of Pain (IASP) Consensus. It previously referred to by several other names, such as Reflex Sympathetic Dystrophy, Causalgia, Algodystrophy or Sudecks Atrophy, and is a disease where the understanding of clinical limits, pathophysiology and pathogenic implications is still very poor. Thus resulting in disappointment both for patients and for health professionals with regard to currently available therapies. This study aimed at reviewing the literature and updating information to improve the understanding of this severe painful syndrome. CONTENTS: This study is a literature review of several CRPS aspects, with emphasis in its causes, definition and taxonomy, pathophysiology, clinical characteristics, diagnostic tests and most recent therapies. CONCLUSIONS: There are few well controlled, double blind and randomized CRPS studies with large samples, and there are still several questions about this disease. The treatment is usually empirical and the patient outcome is poor.

Keywords

PAIN, PAIN

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Síndrome dolorosa complexa regional: epidemiologia, fisiopatologia, manifestações clínicas, testes diagnósticos e propostas terapêuticas

Complex regional pain syndrome: epidemiology, pathophysiology, clinical manifestations, diagnostic tests and therapeutic proposals

Francisco Carlos Obata Cordon; Lino Lemonica

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