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Joint Bone Spine
Volume 73, n° 5
pages 495-499 (octobre 2006)
Doi : 10.1016/j.jbspin.2005.11.022
Received : 12 September 2005 ;  accepted : 30 November 2005
Current management of reflex sympathetic dystrophy syndrome (complex regional pain syndrome type I)
 

Jean-Marie Berthelot
Service de rhumatologie, Hôtel-Dieu, CHU de Nantes, 1, place Alexis, Nantes cedex 01, France 

Abstract

Although no major advances have occurred in the curative treatment of reflex sympathetic dystrophy syndrome (RSDS), new pathogenic insights may soon lead to innovative approaches, which may also prove effective in alleviating some forms of neuropathic pain. Preventing nerve compression and ischemia-reperfusion injury constitute valuable measures for preventing RSDS. Vitamin C administration can also prevent RSDS, together with clonidine in high-risk patients. Short-term glucocorticoid therapy has been found effective in preventing RSDS after stroke but has not been evaluated in other situations. Beneficial effects of bisphosphonates have been documented in several placebo-controlled trials. Placebo-controlled trials of ketamine and spinal cord stimulation are in order to confirm or refute the promising results obtained in open-label studies. Mirror visual feedback was introduced recently for the rehabilitation of patients with RSDS but needs to be evaluated in randomized controlled trials.

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Keywords : Reflex sympathetic dystrophy syndrome, Bisphosphonates, Treatment, Mirror visual feedback




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