REFLEX SYMPATHETIC DYSTROPHY - CHANGING CONCEPTS AND TAXONOMY

We present a revised taxonomic system for disorders previously called reflex sympathetic dystrophy (RSD) and causalgia. The system resulted from a special consensus conference that was convened on this topic an d is based upon the patient's history, presenting symptoms, and findin gs at the time of diagnosis. The disorders are grouped under the umbre lla term CRPS: complex regional pain syndrome. This overall term, CRPS , requires the presence of regional pain and sensory changes following a noxious event. Further, the pain is associated with findings such a s abnormal skin color, temperature change, abnormal sudomotor activity , or edema. The combination of these findings exceeds their expected m agnitude in response to known physical damage during and following the inciting event. Two types of CRPS have been recognized: type I, corre sponds to RSD and occurs without a definable nerve lesion, and type II , formerly called causalgia refers to cases where a definable nerve le sion is present. The term sympathetically maintained pain (SMP) was al so evaluated and considered to be a variable phenomenon associated wit h a variety of disorders, including CRPS types I and II. These revised categories have been included in the 2nd edition of the IASP Classifi cation of Chronic Pain Syndromes.