DISTAL EDEMA AND HYPERHIDROSIS OF THE ARM - SYMPTOMS OF REFLEX SYMPATHETIC DYSTROPHY (SUDECKS-DISEASE)

Reflex sympathetic dystrophy is characterized clinically by the triad of autonomic sympathetic dysfunction, and motor and sensory disturbanc es of the affected extremity. Typical symptoms are distal generalized edema with cyanotic skin, pathologic function of eccrine sweat glands and diffuse dull pain. If reflex sympathetic dystrophy is not recogniz ed an irreversible stage may be reached, with atrophic pale, cool, and anhidrotic skin, contractures and diffuse osteoporosis. The syndrome can be idiopathic but can also be precipated by a variety of factors, including banal trauma, bone fracture, and traumatic nerve lesions. Pa thophysiologically, a functional disturbance of sympathetic nerve fibr es may result in a vicious circle of blood flow dysfunction, excitatio n of afferent nociceptors and maintenance of sympathetic dysfunction a t the level of the spinal or central nervous system. In the patient pr esented in this paper, sympathetic dysregulation of reflex sympathetic dystrophy was cured by means of blockades of the stellate ganglion.