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Effects of cutaneous histamine application in patients with sympathetic reflex dystrophy
Author(s) -
Birklein Frank,
Claus Detlef,
Riedl Bernhard,
Neundörfer Bernhard,
Handwerker Hermann O.
Publication year - 1997
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(199711)20:11<1389::aid-mus6>3.0.co;2-6
Subject(s) - axon reflex , reflex , nociception , itching , medicine , anesthesia , sensitization , histamine , dystrophy , visual analogue scale , sensation , vasodilation , surgery , psychology , neuroscience , pathology , receptor , immunology
Thirty‐six patients suffering from acute reflex sympathetic dystrophy (RSD) were examined in order to evaluate nociceptive C‐fibers. Axon reflex vasodilatation was induced by iontophoresis of histamine and recorded (laser Doppler flux). The strength of concomitant sensation was rated on a visual analogue scale, and the quality was characterized as itching or burning pain. Skin temperature was recorded by infrared thermography. The results were compared with investigations of unaffected limbs of patients and volunteers. The histamine‐induced sensation on the symptomatic side was more often burning pain than itching ( P < 0.001), and skin temperature was increased on the affected limb ( P < 0.001). Axon reflex vasodilatation and the strength of sensations were unaltered. In conclusion, this study rules out a significant deterioration of afferent C‐fibers in RSD, but gives evidence of sensitization of nociceptive function. This nociceptive sensitization has to be taken into consideration for effective treatment of RSD. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20: 1389–1395, 1997