Systemic Complications of Complex Regional Pain Syndrome


Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder that is characterized by: 1) Severe pain beyond the area of injury; 2) Autonomic dysregulation; 3) Neuropathic edema; 4) A movement disorder, atrophy and dystrophy. It is most often caused by a fracture, soft-tissue injury or surgical procedure and is divided into Type I, in which no nerve lesion is identified (classic reflex sympathetic dystrophy), and Type II where a specific nerve has been damaged (causalgia). In addition to the peripheral manifestations, there are many internal medical complications whose etiology is often not appreciated. This article will examine how CRPS affects the systems of: cognition; constitutional, cardiac, and respiratory complications; systemic autonomic dysregulation; neurogenic edema; musculoskeletal, endocrine and dermatological manifestations; as well as urological and gastrointestinal function.

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R. Schwartzman, "Systemic Complications of Complex Regional Pain Syndrome," Neuroscience and Medicine, Vol. 3 No. 3, 2012, pp. 225-242. doi: 10.4236/nm.2012.33027.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] R. J. Schwartzman, K. L. Erwin and G. M. Alexander, “The Natural History of Complex Regional Pain Syndrome,” The Clinical Journal of Pain, Vol. 25, No. 4, 2009, pp. 273-80. doi:10.1097/AJP.0b013e31818ecea5
[2] A. L Oaklander and H. L. Fields, “Is Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome type I a Small-Fiber Neuropathy?” Annals of Neurology, Vol. 65, No. 6, 2009, pp. 629-638. doi:10.1002/ana.21692
[3] R. N. Harden, S. Bruehl, B. S. Galer, S. Saltz, M. Bertram, M. Backonja, et al., “Complex Regional Pain Syndrome: Are the Iasp Diagnostic Criteria Valid And Sufficiently Comprehensive?” Pain, Vol. 83, No. 2, 1999, pp. 211- 219.
[4] S. Bruehl, R. N. Harden, B. S. Galer, S. Saltz, M. Backonja and M. Stanton-Hicks, “Complex Regional Pain Syndrome: Are There Distinct Subtypes and Sequential Stages of the Syndrome?” Pain, Vol. 95, No. 1-2, 2002, pp. 119-124.
[5] S. Bruehl, R. N. Harden, B. S. Galer, S. Saltz, M. Bertram, M. Backonja, et al., “External Validation of IASP Diagnostic Criteria for Complex Regional Pain Syndrome and Proposed Research Diagnostic Criteria. International Association for the Study of Pain,” Pain, Vol. 81, No. 1-2, 1999, pp. 147-154.
[6] R. N. Harden and S. Bruehl, “Diagnostic Criteria: The Statistical Derivation of the Four Criterion Factors,” In: P. R. Wilson, M. D. Stanton-Hicks and R. N. Harden, Eds., CRPS: Current Diagnosis and Therapy, IASP Press, Seattle, 2005, pp. 45-58.
[7] R. N. Harden, S. Bruehl, R. S. Perez, F. Birklein, J. Marinus, C. Maihofner, et al., “Validation of Proposed Diagnostic Criteria (the “Budapest Criteria”) for Complex Regional Pain Syndrome,” Pain, Vol. 150, No. 2, 2010, pp. 268-274. doi:10.1016/j.pain.2010.04.030
[8] P. H. Veldman and R. J. Goris, “Surgery on Extremities with Reflex Sympathetic Dystrophy,” Unfallchirurg, Vol. 98, No. 1, 1995, pp. 45-48.
[9] J. Maleki, A. A. LeBel, G. J. Bennett and R. J. Schwartzman, “Patterns of Spread in Complex Regional Pain Syndrome, Type I (Reflex Sympathetic Dystrophy),” Pain, Vol. 88, No. 3, 2000, pp. 259-266.
[10] O. Rommel, M. Gehling, R. Dertwinkel, K. Witscher, M. Zenz, J. P. Malin, et al., “Hemisensory Impairment in Patients with Complex Regional Pain Syndrome,” Pain, Vol. 80, No. 1-2, 1999, pp. 95-101.
[11] M. A. van Rijn, J. Marinus, H. Putter, S. R. Bosselaar, G. L. Moseley and J. J. van Hilten, “Spreading of Complex Regional Pain Syndrome: Not a Random Process,” Journal of Neural Transmission, Vol. 118, No. 9, 2011, pp. 1301-1309. doi:10.1007/s00702-011-0601-1
[12] R. J. Schwartzman and J. R. Grothusen, “Brachial Plexus Traction Injury: Quantification of Sensory Abnormalities,” Pain Medicine, Vol. 9, No. 7, 2008, pp. 950-957. doi:10.1111/j.1526-4637.2007.00394.x
[13] J. W. Rasmussen, J. R. Grothusen, A. L. Rosso and R. J. Schwartzman, “Atypical Chest Pain: Evidence of Intercostobrachial Nerve Sensitization in Complex Regional Pain Syndrome,” Pain Physician, Vol. 12, No. 5, 2009, pp. E329-E234.
[14] M. de Mos, A. G. de Bruijn, F. J. Huygen, J. P. Dieleman, B. H. Stricker and M. C. Sturkenboom, “The Incidence of Complex Regional Pain Syndrome: A Population-Based Study,” Pain, Vol. 129, No. 1-2, 2007, pp. 12-20. doi:10.1016/j.pain.2006.09.008
[15] P. H. Veldman, H. M. Reynen, I. E. Arntz and R. J. Goris, “Signs and Symptoms of Reflex Sympathetic Dystrophy: Prospective Study of 829 Patients,” Lancet, Vol. 342, No. 8878, 1993, pp. 1012-1016.
[16] P. U. Dijkstra, J. W. Groothoff, H. J. Duis and J. H. Geertzen, “Incidence of Complex Regional Pain Syndrome Type I after Fractures of the Distal Radius,” European Journal of Pain, Vol. 7, No. 5, 2003, pp. 457- 462.
[17] D. R. Bickerstaff and J. A. Kanis, “Algodystrophy: An Under-Recognized Complication of Minor Trauma,” British Journal of Rheumatology, Vol. 33, No. 3, 1994, pp. 240-248.
[18] A. Zyluk, “The Natural History of Post-Traumatic Reflex Sympathetic Dystrophy,” Journal of Hand Surgery, Vol. 23, No. 1, 1998, pp. 20-23.
[19] P. Sandroni, L. M. Benrud-Larson, R. L. McClelland and P. A Low, “Complex Regional Pain Syndrome Type I: Incidence and Prevalence in Olmsted County, a Population-Based Study,” Pain, Vol. 103, No. 1-2, 2003, pp. 199-207.
[20] W. Janig and R. Baron, “Complex Regional Pain Syndrome: Mystery Explained?” Lancet Neurology, Vol. 2, No. 11, 2003, pp. 687-697.
[21] R. P. Hart, M. F. Martelli and N. D. Zasler, “Chronic Pain and Neuropsychological Functioning,” Neuropsychology Review, Vol. 10, No. 3, 2000, pp. 131-149.
[22] B. D. Dick and S. Rashiq, “Disruption of Attention and Working Memory Traces in Individuals with Chronic Pain,” Anesthesia & Analgesia, Vol. 104, No. 5, 2007, pp. 1223-1229. doi:10.1213/01.ane.0000263280.49786.f5
[23] D. K. Weiner, T. E. Rudy, L. Morrow, J. Slaboda and S. Lieber, “The Relationship between Pain, Neuropsychological Performance, and Physical Function in Community-Dwelling Older Adults with Chronic Low Back Pain,” Pain Medicine, Vol. 7, No. 1, 2006, pp. 60-70. doi:10.1111/j.1526-4637.2006.00091.x
[24] J. F. Karp, C. F. Reynolds 3rd, M. A. Butters, M. A. Dew, S. Mazumdar, A. E. Begley, et al., “The Relationship between Pain and Mental Flexibility in Older Adult Pain Clinic Patients,” Pain Medicine, Vol. 7, No. 5, 2006, pp. 444-452. doi:10.1111/j.1526-4637.2006.00212.x
[25] R. N. Harden, S. Bruehl, M. Stanton-Hicks and P. R. Wilson, “Proposed New Diagnostic Criteria for Complex Regional Pain Syndrome,” Pain Medicine, Vol. 8, No. 4, 2007, pp. 326-331. doi:10.1111/j.1526-4637.2006.00169.x
[26] D. J. Libon, R. J. Schwartzman, J. Eppig, D. Wambach, E. Brahin, B. L. Peterlin, et al., “Neuropsychological Deficits Associated with Complex Regional Pain Syndrome,” Journal of the International Neuropsychological Society, Vol. 16, No. 3, 2010, pp. 566-573. doi:10.1017/S1355617710000214
[27] D. Wechsler, “Wechsler Adult Intelligence Scale,” 3rd Edition, The Psychological Corporation, San Antonio, 1997.
[28] M. Lamar, C. C. Price, D. J. Libon, D. L. Penney, E. Kaplan, M. Grossman, et al., “Alterations in Working Memory as a Function of Leukoaraiosis in Dementia,” Neuropsychologia, Vol. 45, No. 2, 2007, pp. 245-254. doi:10.1016/j.neuropsychologia.2006.07.009
[29] M. Lamar, M. Catani, C. C. Price, K. M. Heilman and D. J. Libon, “The Impact of Region-Specific Leukoaraiosis on Working Memory Deficits in Dementia,” Neuropsychologia, Vol. 46, No. 10, 2008, pp. 2597-2601. doi:10.1016/j.neuropsychologia.2008.04.007
[30] E. A. Phelps, F. Hyder, A. M. Blamire and R. G. Shulman, “FMRI of the Prefrontal Cortex during Overt Verbal Fluency,” Neuroreport, Vol. 8, No. 2, 1997, pp. 561-565.
[31] E. Kaplan, H. Goodglass and S. Weintrab, “The Boston Naming Test,” 2nd Edition, Lea & Febiger, Philadelphia, 1983.
[32] J. A. Gladsjo, C. C. Schuman, J. D. Evans, G. M. Peavy, S. W. Miller and R. K. Heaton, “Norms for Letter and Category Fluency: Demographic Corrections for Age, Education, and Ethnicity,” Assessment, Vol. 6, No. 2, 1999, pp. 147-178.
[33] C. J. Mummery, K. Patterson, J. R. Hodges and R. J. Wise, “Generating ‘tiger’ as an Animal Name or a Word Beginning with T: Differences in Brain Activation,” Proceedings of the Royal Society, Vol. 263, No. 1373, 1996, pp. 989-995. doi:10.1098/rspb.1996.0146
[34] D. J. Libon, C. McMillan, D. Gunawardena, C. Powers, L. Massimo, A. Khan, et al., “Neurocognitive Contributions to Verbal Fluency Deficits in Frontotemporal Lobar Degeneration,” Neurology, Vol. 73, No. 7, 2009, pp. 535- 542. doi:10.1212/WNL.0b013e3181b2a4f5
[35] D. C. Delis, J. H. Kramer, E. Kaplan and B. A. Ober, “California Verbal Learning Test,” 2nd Edition, Psychological Corporation, San Antonio, 2000.
[36] R. Melzack, “The Short-Form McGill Pain Questionnaire,” Pain, Vol. 30, No. 2, 1987, pp. 191-197.
[37] . T. Beck A, R. A. Steer and G. K. Brown, “Manual for the Beck Depression Inventory-II,” Psychological Corporation, San Antonio, 1996.
[38] C. C. Price, K. D. Garrett, A. L. Jefferson, S. Cosentino, J. J. Tanner, D. L. Penney, et al., “Leukoaraiosis Severity and List-Learning in Dementia,” Clinical Neuropsychology, Vol. 23, No. 6, 2009, pp. 944-961. doi:10.1080/13854040802681664
[39] R. T. Kiefer, P. Rohr, K. Unertl, K. H. Altemeyer, J. Grothusen and R. J. Schwartzman, “Recovery from Intractable Complex Regional Pain Syndrome Type I (RSD) under High-Dose Intravenous Ketamine-Midazolam Sedation,” Neurology, Vol. 58, No. 7, 2002, pp. A474- A475.
[40] S. P. Koffler, B. M. Hampstead, F. Irani, J. Tinker, R. T. Kiefer, P. Rohr, et al., “The Neurocognitive Effects of 5 Day Anesthetic Ketamine for the Treatment of Refractory Complex Regional Pain Syndrome,” Archives of Clinical Neuropsychology, Vol. 22, No. 6, 2007, pp. 719-729. doi:10.1016/j.acn.2007.05.005
[41] C. Maihofner, H. O. Handwerker, B. Neundorfer and F. Birklein, “Patterns of Cortical Reorganization in Complex Regional Pain Syndrome,” Neurology, Vol. 61, No. 12, 2003, pp. 1707-1715.
[42] C. Maihofner, H. O. Handwerker, B. Neundorfer and F. Birklein, “Cortical Reorganization during Recovery from Complex Regional Pain Syndrome,” Neurology, Vol. 63, No. 4, 2004, pp. 693-701. doi:63/4/693
[43] B. Pleger, M. Tegenthoff, P. Ragert, A. F. Forster, H. R. Dinse, P. Schwenkreis, et al., “Sensorimotor Retuning [Corrected] in Complex Regional Pain Syndrome Parallels Pain Reduction,” Annals of Neurology, Vol. 57, No. 3, 2005, pp. 425-429. doi:10.1002/ana.20394
[44] E. Peltz, F. Seifert, S. Lanz, R. Muller and C. Maihofner, “Impaired Hand Size Estimation in CRPS,” Journal of Pain, Vol. 12, No. 10, 2011, pp. 1095-1101. doi:10.1016/j.jpain.2011.05.001
[45] J. S. Lewis, P. Kersten, K. M. McPherson, G. J. Taylor, N. Harris, C. S. McCabe, et al., “Wherever Is My Arm? Impaired Upper Limb Position Accuracy in Complex Regional Pain Syndrome,” Pain, Vol. 149, No. 3, 2010, pp. 463-469. doi:10.1016/j.pain.2010.02.007
[46] S. Forderreuther, U. Sailer and A. Straube, “Impaired Self-Perception of the Hand in Complex Regional Pain Syndrome (CRPS),” Pain, Vol. 110, No. 3, 2004, pp. 756-761. doi:10.1016/j.pain.2004.05.019
[47] J. Frettloh, M. Huppe and C. Maier, “Severity and Specificity of Neglect-Like Symptoms in Patients with Complex Regional Pain Syndrome (CRPS) Compared to Chronic Limb Pain of Other Origins,” Pain, Vol. 124, No. 1-2, 2006, pp. 184-189. doi:10.1016/j.pain.2006.04.010
[48] B. Pleger, P. Ragert, P. Schwenkreis, A. F. Forster, C. Wilimzig, H. Dinse, et al., “Patterns of Cortical Reorganization Parallel Impaired Tactile Discrimination and Pain Intensity in Complex Regional Pain Syndrome,” Neuroimage, Vol. 32, No. 2, 2006, pp. 503-510. doi:10.1016/j.neuroimage.2006.03.045
[49] A. Lebel, L. Becerra, D. Wallin, E. A. Moulton, S. Morris, G. Pendse, et al., “fMRI Reveals Distinct Cns Processing during Symptomatic and Recovered Complex Regional Pain Syndrome in Children,” Brain, Vol. 131, No. 7, 2008, pp. 1854-1879. doi:10.1093/brain/awn123
[50] G. Robinson, H. Cohen and A. Goebel, “A Case of Complex Regional Pain Syndrome with Agnosia for Object Orientation,” Pain, Vol. 152, No. 7, 2011, pp. 1674-1681. doi:10.1016/j.pain.2011.02.010
[51] C. Maihofner, R. Baron, R. DeCol, A. Binder, F. Birklein, G. Deuschl, et al., “The Motor System Shows Adaptive Changes in Complex Regional Pain Syndrome,” Brain, Vol. 130, No. 10, 2007, pp. 2671-2687. doi:10.1093/brain/awm131
[52] A. May, “Chronic Pain May Change the Structure of the Brain,” Pain, Vol. 137, No. 1, 2008, pp. 7-15. doi:10.1016/j.pain.2008.02.034
[53] A. V. Apkarian, Y. Sosa, S. Sonty, R. M. Levy, R. N. Harden, T. B. Parrish, et al., “Chronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density,” Journal of Neuroscience, Vol. 24, No. 46, 2004, pp. 10410-10415. doi:10.1523/JNEUROSCI.2541-04.2004
[54] P. G. Patil, J. L. Apfelbaum and J. P. Zacny, “Effects of a Cold-Water Stressor On Psychomotor and Cognitive Functioning in Humans,” Physiol Behav, Vol. 58, No. 6, 1995, pp. 1281-1286.
[55] N. Terrando, L. I. Eriksson, J. K. Ryu, T. Yang, C. Monaco, M. Feldmann, et al., “Resolving Postoperative Neuroinflammation and Cognitive Decline,” Annals of Neurology, Vol. 70, No. 6, 2011, pp. 986-995. doi:10.1002/ana.22664
[56] Y. Arima, M. Harada, D. Kamimura, J. H. Park, F. Kawano, F. E. Yull, et al., “Regional Neural Activation Defines a Gateway for Autoreactive T Cells to Cross the Blood-Brain Barrier,” Cell, Vol. 148, No. 3, 2012, pp. 447-457. doi:10.1016/j.cell.2012.01.022
[57] F. Marchand, M. Perretti and S. B. McMahon, “Role of the Immune System in Chronic Pain,” Nature Reviews Neuroscience, Vol. 6, No. 7, 2005, pp. 521-532. doi:10.1038/nrn1700
[58] F. J. Huygen, N. Ramdhani, A. van Toorenenbergen, J. Klein and F. J. Zijlstra, “Mast Cells Are Involved in Inflammatory Reactions during Complex Regional Pain Syndrome Type 1,” Immunology Letters, Vol. 91, No. 2-3, 2004, pp. 147-154. doi:10.1016/j.imlet.2003.11.013
[59] J. G. Groeneweg, F. J. Huygen, C. Heijmans-Antonissen, S. Niehof and F J. Zijlstra, “Increased Endothelin-1 and Diminished Nitric Oxide Levels in Blister Fluids of Patients with Intermediate Cold Type Complex Regional Pain Syndrome Type 1,” BMC Musculoskeletal Disorders, Vol. 7, No. 2006, p. 91. doi:10.1186/1471-2474-7-91
[60] F. Wesseldijk, D. Fekkes, F. J. Huygen, M. van de Heide-Mulder and F. J. Zijlstra, “Increased Plasma Glutamate, Glycine, and Arginine Levels in Complex Regional Pain Syndrome Type 1,” Acta Anaesthesiologica Scandinavica, Vol. 52, No. 5, 2008, pp. 688-694. doi:10.1111/j.1399-6576.2008.01638.x
[61] H. H. Kramer, T. Eberle, N. Uceyler, I. Wagner, T. Klonschinsky, L. P. Muller, et al., “TNF-Alpha in CRPS and ‘Normal’ Trauma-Significant Differences between Tissue and Serum,” Pain, Vol. 152, No. 2, 2011, pp. 285-290. doi:10.1016/j.pain.2010.09.024
[62] N. Uceyler, J. P. Rogausch, K. V. Toyka and C. Sommer, “Differential Expression of Cytokines in Painful and Painless Neuropathies,” Neurology, Vol. 69, No. 1, 2007, pp. 42-49. doi:10.1212/01.wnl.0000265062.92340.a5
[63] G. M. Alexander, M. A. van Rijn, J. J. van Hilten, M. J. Perreault and R. J. Schwartzman, “Changes in Cerebrospinal Fluid Levels of Pro-Inflammatory Cytokines in CRPS,” Pain, Vol. 116, No. 3, 2005, pp. 213-219. doi:10.1016/j.pain.2005.04.013
[64] G. M. Alexander, M. J. Perreault, E. R. Reichenberger and R. J. Schwartzman, “Changes in Immune and Glial Markers in the Csf of Patients with Complex Regional Pain Syndrome,” Brain, Behavior, and Immunity, Vol. 21, No. 5, 2007, pp. 668-676. doi:10.1016/j.bbi.2006.10.009
[65] F. J. Huygen, A. G. de Bruijn, J. Klein and F. J. Zijlstra, “Neuroimmune Alterations in the Complex Regional Pain Syndrome,” European Journal of Pharmacology, Vol. 429, No. 1-3, 2001, pp. 101-113.
[66] B. W. Ritz, G. M. Alexander, S. Nogusa, M. J. Perreault, B. L. Peterlin, J. R. Grothusen, et al., “Elevated Blood Levels of Inflammatory Monocytes (CD14(+) CD16(+) ) in Patients with Complex Regional Pain Syndrome,” Clinical & Experimental Immunology, Vol. 164, No. 1, 2011, pp. 108-117. doi:10.1111/j.1365-2249.2010.04308.x
[67] F. Blaes, K. Schmitz, M. Tschernatsch, M. Kaps, I. Krasenbrink, G. Hempelmann, et al., “Autoimmune Etiology of Complex Regional Pain Syndrome (M. Sudeck),” Neurology, Vol. 63, No. 9, 2004, pp. 1734-1736.
[68] D. Kohr, M. Tschernatsch, K. Schmitz, P. Singh, M. Kaps, K. H. Schafer, et al., “Autoantibodies in Complex Regional Pain Syndrome Bind to a Differentiation-Dependent Neuronal Surface Autoantigen,” Pain, Vol. 143, No. 3, 2009, pp. 246-251. doi:10.1016/j.pain.2009.03.009
[69] L. R. Watkins and S. F. Maier, “The Pain of Being Sick: Implications of Immune-to-Brain Communication for Understanding Pain,” Annual Review of Psychology, Vol. 51, No. 2000, 2000, pp. 29-57. doi:10.1146/annurev.psych.51.1.29
[70] L. E. Goehler, R. P. Gaykema, S. E. Hammack, S. F. Maier and L. R. Watkins, “Interleukin-1 Induces c-Fos Immunoreactivity in Primary Afferent Neurons of the Vagus Nerve,” Brain Research, Vol. 804, No. 2, 1998, pp. 306-310.
[71] L. E. Goehler, R. P. Gaykema, K. T. Nguyen, J. E. Lee, F. J. Tilders, S. F. Maier, et al., “Interleukin-1Beta in Immune Cells of the Abdominal Vagus Nerve: A Link between the Immune and Nervous Systems?” Journal of Neuroscience, Vol. 19, No. 7, 1999, pp. 2799-2806.
[72] L. R. Watkins and S. F. Maier, “Implications of Immune- to-Brain Communication for Sickness and Pain,” Proceedings of the National Academy of Sciences USA, Vol. 96, No. 14, 1999, pp. 7710-7713.
[73] H. E. Romeo, D. L. Tio, S. U. Rahman, F. Chiappelli and A. N. Taylor, “The Glossopharyngeal Nerve as a Novel Pathway in Immune-to-Brain Communication: Relevance to Neuroimmune Surveillance of the Oral Cavity,” Journal of Neuroimmunology, Vol. 115, No. 1-2, 2001, pp. 91-100.
[74] S. Laye, R. M. Bluthe, S. Kent, C. Combe, C. Medina, P. Parnet, et al., “Subdiaphragmatic Vagotomy Blocks Induction of Il-1 Beta Mrna in Mice Brain in Response to Peripheral LPS,” American Journal of Physiology, Vol. 268, No. 5, 1995, pp. R1327-R1331.
[75] P. Mason, “Lipopolysaccharide Induces Fever and Decreases Tail Flick Latency in Awake Rats,” Neuroscience Letters, Vol. 154, No. 1-2, 1993, pp. 134-136.
[76] L. R. Watkins, L. E. Goehler, J. Relton, M. T. Brewer and S. F. Maier, “Mechanisms of Tumor Necrosis Factor- Alpha (Tnf-Alpha) Hyperalgesia,” Brain Research, Vol. 692, No. 1-2, 1995, pp. 244-250.
[77] L. R. Watkins, L. E. Goehler, J. K. Relton, N. Tartaglia, L. Silbert, D. Martin, et al., “Blockade of Interleukin-1 Induced Hyperthermia by Subdiaphragmatic Vagotomy: Evidence for Vagal Mediation of Immune-Brain Communication,” Neuroscience Letters, Vol. 183, No. 1-2, 1995, pp. 27-31.
[78] J. A. Smith, D. G. Karalis, A. L. Rosso, J. R. Grothusen, S. E. Hessen and R. J. Schwartzman, “Syncope in Complex Regional Pain Syndrome,” Clinical Cardiology, Vol. 34, No. 4, 2011, pp. 222-225. doi:10.1002/clc.20879
[79] M Brignole, C Menozzi, A Del Rosso, S Costa, G Gaggi-oli, N Bottoni, et al., “New Classification of Haemodynamics of Vasovagal Syncope: Beyond the VASIS Classification. Analysis of the Pre-Syncopal Phase of the Tilt Test without and with Nitroglycerin Challenge. Vasovagal Syncope International Study,” Europace, Vol. 2, No. 1, 2000, pp. 66-76.
[80] A. J. Aerts and P. Dendale, “Diagnostic Value of Nitrate Stimulated Tilt Testing without Preceding Passive Tilt in Patients with Suspected Vasovagal Syncope and a Healthy Control Group,” Pacing and Clinical Electrophysiology, Vol. 28, No. 1, 2005, pp. 29-32. doi:10.1111/j.1540-8159.2005.09439.x
[81] F. Radrigan, E. Dumas, G. Chamorro, P. Casanegra, J. Jalil, “Head-Up Tilt Test in Healthy Asymptomatic Patients,” Revista Medica de Chile, Vol. 124, No. 10, 1996, pp. 1187-1191.
[82] B. P. Grubb, D. Kosinski, P. Temesy-Armos and P. Brewster, “Responses of Normal Subjects during 80 Degrees Head Upright Tilt Table Testing with and without Low Dose Isoproterenol Infusion,” Pacing and Clinical Electrophysiology, Vol. 20, No. 8, 1997, pp. 2019-2023.
[83] C. Podoleanu, A. Frigy, D. Dobreanu, S. Micu, D. Podoleanu, A. Incze, et al., “Study of the Efficiency of the Head-Up Tilt Test with Nitroglycerin Challenge in the Diagnosis of Vasovagal Syncope,” Romanian Journal of Internal Medicine—Revue Roumaine de Medecine Interne, Vol. 42, No. 3, 2004, pp. 585-594.
[84] P. M. Meier, M. E. Alexander, N. F. Sethna, C. C. De Jong-De Vos Van Steenwijk, D. Zurakowski and C. B. Berde, “Complex Regional Pain Syndromes in Children and Adolescents: Regional and Systemic Signs and Symptoms and Hemodynamic Response to Tilt Table Testing,” The Clinical Journal of Pain, Vol. 22, No. 4, 2006, pp. 399-406. doi:10.1097/01.ajp.0000192514.50955.d6
[85] A. J. Terkelsen, M. Holgaard, J. Hansen, N. B. Finnerup, K. Kroner and T. S. Jensen, “Heart Rate Variability in Complex Regional Pain Syndrome during Rest and Mental and Orthostatic Stress,” Anesthesiology, Vol. 116, No. 1, 2012, pp. 133-146. doi:10.1097/ALN.0b013e31823bbfb0
[86] D. L. Eckberg, “Physiological Basis for Human Autonomic Rhythms,” Annals of Medicine, Vol. 32, No. 5, 2000, pp. 341-349.
[87] E. M. Holper and D. P. Faxon, “Percutaneous Coronary Intervention in Women,” Journal of the American Medical Women’s Association, Vol. 58, No. 4, 2003, pp. 264- 271.
[88] J. M. DeCara, “Noninvasive Cardiac Testing in Women,” Journal of the American Medical Women’s Association, Vol. 58, No. 4, 2003, pp. 254-263.
[89] G. Pontone, D. Andreini, G. Ballerini, E. Nobili and M. Pepi, “Diagnostic Work-Up of Unselected Patients with Suspected Coronary Artery Disease: Complementary Role of Multidetector Computed Tomography, Symptoms and Electrocardiogram Stress Test,” Coronary Artery Disease, Vol. 18, No. 4, 2007, pp. 265-274. doi:10.1097/MCA.0b013e328035f8ae
[90] M. E. Goldberg, R. J. Schwartzman, R. Domsky, M. Sabia and M. C. Torjman, “Deep Cervical Plexus Block for the Treatment of Cervicogenic Headache,” Pain Physician, Vol. 11, No. 6, 2008, pp. 849-854.
[91] C. J. Woolf and M. W. Salter, “Neuronal Plasticity: Increasing the Gain in Pain,” Science, Vol. 288, No. 5472, 2000, pp. 1765-1769.
[92] M. G. O’Rourke, T. S. Tang, S. I. Allison and W. Wood, “The Anatomy of the Extrathoracic Intercostobrachial Nerve,” The Australian and New Zealand Journal of Surgery, Vol. 69, No. 12, 1999, pp. 860-864.
[93] M. Loukas, R. G. Louis Jr., Q. A. Fogg, B. Hallner and A. A. Gupta, “An Unusual Innervation of Pectoralis Minor and Major Muscles from a Branch of the Intercostobrachial Nerve,” Clinical Anatomy, Vol. 19, No. 4, 2006, pp. 347-349. doi:10.1002/ca.20284
[94] M. Loukas, J. Hullett, R. G. Louis Jr., S. Holdman and D. Holdman, “The Gross Anatomy of the Extrathoracic Course of the Intercostobrachial Nerve,” Clinical Anatomy, Vol. 19, No. 2, 2006, pp. 106-111. doi:10.1002/ca.20226
[95] M. Loukas, R. G. Louis Jr. and C. T. Wartmann, “T2 Contributions to the Brachial Plexus,” Neurosurgery, Vol. 60, No. 2, 2007, pp. ONS13- ONS 18. doi:10.1227/01.NEU.0000249234.20484.2A
[96] K. O. Taylor, “Morbidity Associated with Axillary Surgery for Breast Cancer,” ANZ Journal of Surgery, Vol. 74, No. 5, 2004, pp. 314-317. doi:10.1111/j.1445-1433.2004.02992.x
[97] R. B. Steinberg and K. Stueber, “Sympathetically Mediated Pain after Reduction Mammoplasty: An Unusual Complication,” Journal of Clinical Anesthesia, Vol. 10, No. 3, 1998, pp. 246-248.
[98] F. A. Papay, A. Verghese, M. Stanton-Hicks and J. Zins, “Complex Regional Pain Syndrome of the Breast in a Patient after Breast Reduction,” Annals of Plastic Surgery, Vol. 39, No. 4, 1997, pp. 347-352.
[99] R. J. Schwartzman and J. Kerrigan, “The Movement Disorder of Reflex Sympathetic Dystrophy,” Neurology, Vol. 40, No. 1, 1990, pp. 57-61.
[100] G. D. Schott, “Peripherally-Triggered CRPS and Dystonia,” Pain, Vol. 130, No. 3, 2007, pp. 203-207. doi:10.1016/j.pain.2007.04.013
[101] M. A. van Rijn, J. Marinus, H. Putter and J. J. van Hilten, “Onset and Progression of Dystonia in Complex Regional Pain Syndrome,” Pain, Vol. 130, No. 3, 2007, pp. 287- 293. doi:10.1016/j.pain.2007.03.027
[102] J. J. Van Hilten, H. P. D. Blumberg and R. J. Schwartzman, “Factor IV: Movement Disorders and Dystrophy: Clinical and Pathophysiological Aspects,” In: P. R. Wilson, M. Stanton-Hicks and R. N. Harden, Eds., CRPS: Current Diagnosis and Therapy, IASP Press, Seattle, 2005.
[103] D. J. Irwin and R. J. Schwartzman, “Complex Regional Pain Syndrome with Associated Chest Wall Dystonia: A Case Report,” Journal of Brachial Plexus and Peripheral Nerve Injury, Vol. 6, No. 2011, p. 6. doi:10.1186/1749-7221-6-6
[104] E. K. Krumova, J. Frettloh, S. Klauenberg, H. Richter, G. Wasner and C. Maier, “Long-Term Skin Temperature Measurements—A Practical Diagnostic Tool In Complex Regional Pain Syndrome,” Pain, Vol. 140, No. 1, 2008, pp. 8-22. doi:10.1016/j.pain.2008.07.003
[105] G. Wasner, J. Schattschneider, K. Heckmann, C. Maier and R. Baron, “Vascular Abnormalities in Reflex Sympathetic Dystrophy (Crps I): Mechanisms and Diagnostic Value,” Brain, Vol. 124, No. 3, 2001, pp. 587-599.
[106] G. Wasner, K. Heckmann, C. Maier and R. Baron, “Vascular Abnormalities in Acute Reflex Sympathetic Dystrophy (Crps I): Complete Inhibition of Sympathetic Nerve Activity with Recovery,” Archives of Neurology, Vol. 56, No. 5, 1999, pp. 613-620.
[107] J. M. Arnold, R. W. Teasell, A. P. MacLeod, J. E. Brown and S. G. Carruthers, “Increased Venous Alpha-Adrenoceptor Responsiveness in Patients with Reflex Sympathetic Dystrophy,” Annals of Internal Medicine, Vol. 118, No. 8, 1993, pp. 619-621.
[108] P. D. Drummond, S. Skipworth and P. M. Finch, “Alpha 1-Adrenoceptors in Normal and Hyperalgesic Human Skin,” Clinical Science (Lond), Vol. 91, No. 1, 1996, pp. 73-77.
[109] T. Eberle, B. Doganci, H. H. Kramer, C. Geber, M. Fechir, W. Magerl, et al., “Warm and Cold Complex Regional Pain Syndromes: Differences beyond Skin Temperature?” Neurology, Vol. 72, No. 6, 2009, pp. 505-512. doi:10.1212/01.wnl.0000341930.35494.66
[110] M. D. Bej and R. J. Schwartzman, “Abnormalities of Cutaneous Blood Flow Regulation in Patients with Reflex Sympathetic Dystrophy as Measured by Laser Doppler fluxmetry,” Archives of Neurology, Vol. 48, No. 9, 1991, pp. 912-915.
[111] M. Schurmann, G. Gradl, H. J. Andress, H. Furst and F. W. Schildberg, “Assessment of Peripheral Sympathetic Nervous Function for Diagnosing Early Post-Traumatic Complex Regional Pain Syndrome Type I,” Pain, Vol. 80, No. 1-2, 1999, pp. 149-159.
[112] G. Gradl and M. Schurmann, “Sympathetic Dysfunction as a Temporary Phenomenon in Acute Posttraumatic CRPS I,” Clinical Autonomic Research, Vol. 15, No. 1, 2005, pp. 29-34. doi:10.1007/s10286-005-0237-z
[113] M. Di Benedetto, C. W. Huston, M. W. Sharp and B. Jones, “Regional Hypothermia in Response to Minor Injury,” American Journal of Physical Medicine & Rehabilitation—Association of Academic Physiatrists, Vol. 75, No. 4, 1996, pp. 270-277.
[114] R. J. Schwartzman and T. L. McLellan, “Reflex Sympathetic Dystrophy. A Review,” Archives of Neurology, Vol. 44, No. 5, 1987, pp. 555-561.
[115] A. J. Terkelsen, F. W. Bach and T. S. Jensen, “Experimental Forearm Immobilization in Humans Induces Cold and Mechanical Hyperalgesia,” Anesthesiology, Vol. 109, No. 2, 2008, pp. 297-307. doi:10.1097/ALN.0b013e31817f4c9d
[116] T. C. Chelimsky, P. A. Low, J. M. Naessens, P. R. Wilson, P. C. Amadio and P. C. O’Brien, “Value of Autonomic Testing in Reflex Sympathetic Dystrophy,” Mayo Clinic Proceedings, Vol. 70, No. 11, 1995, pp. 1029-1040. doi:10.1016/S0025-6196(11)64438-8
[117] K. R. Chemali, R. Gorodeski and T. C. Chelimsky, “Alpha-Adrenergic Supersensitivity of the Sudomotor Nerve in Complex Regional Pain Syndrome,” Annals of Neurology, Vol. 49, No. 4, 2001, pp. 453-459.
[118] R. Baron, J. Schattschneider, A. Binder, D. Siebrecht and G. Wasner, “Relation between Sympathetic Vasoconstrictor Activity and Pain and Hyperalgesia in Complex Regional Pain Syndromes: A Case-Control Study,” Lancet, Vol. 359, No. 9318, 2002, pp. 1655-1660. doi:10.1016/S0140-6736(02)08589-6
[119] R. J. Schwartzman, “The Autonomic Nervous System and Pain,” In: O. Appenzeller, Ed., Handbook of Clinical Neurology the Autonomic Nervous System Part II Dysfunctions, Elsevier Science, Amsterdam, 2000. pp. 309- 347.
[120] P. D. Drummond, P. M. Finch, S. Skipworth and P. Blockey, “Pain Increases during Sympathetic Arousal in Patients with Complex Regional Pain Syndrome,” Neurology, Vol. 57, No. 7, 2001, pp. 1296-1303.
[121] T. J. Coderre, D. N. Xanthos, L. Francis and G. J. Bennett, “Chronic Post-Ischemia Pain (CPIP): A Novel Animal Model of Complex Regional Pain Syndrome-Type I (CRPS-I; Reflex Sympathetic Dystrophy) Produced by Prolonged Hindpaw Ischemia and Reperfusion in the Rat,” Pain, Vol. 112, No. 1-2, 2004, pp. 94-105. doi:10.1016/j.pain.2004.08.001
[122] P. E. Molina, “Noradrenergic Inhibition of TNF Upregulation in Hemorrhagic Shock,” Neuroimmunomodulation, Vol. 9, No. 3, 2001, pp. 125-133.
[123] P. E. Molina, “Neurobiology of the Stress Response: Contribution of the Sympathetic Nervous System to the Neuroimmune Axis in Traumatic Injury,” Shock, Vol. 24, No. 1, 2005, pp. 3-10.
[124] C. Sommer and M. Kress, “Recent Findings on How Proinflammatory Cytokines Cause Pain: Peripheral Mechanisms in Inflammatory and Neuropathic Hyperalgesia,” Neuroscience Letters, Vol. 361, No. 1-3, 2004, pp. 184-187. doi:10.1016/j.neulet.2003.12.007
[125] S. Pezet and S. B. McMahon, “Neurotrophins: Mediators and Modulators of Pain,” Annual Review of Neuroscience, Vol. 29, No. 2006, 2006, pp. 507-538. doi:10.1146/annurev.neuro.29.051605.112929
[126] S. England, S. Bevan and R. J. Docherty, “PGE2 Modulates the Tetrodotoxin-Resistant Sodium Current in Neonatal Rat Dorsal Root Ganglion Neurones via the Cyclic AMP- Protein Kinase A Cascade,” Journal of Physiology, Vol. 495, No. 1996, pp. 429-440.
[127] A. Opree and M. Kress, “Involvement of the Proinflam-matory Cytokines Tumor Necrosis Factor-Alpha, Il-1 Beta, and Il-6 but Not Il-8 in the Development of Heat Hyperalgesia: Effects on Heat-Evoked Calcitonin Gene-Related Peptide Release from Rat Skin,” Journal of Neuroscience, Vol. 20, No. 16, 2000, pp. 6289-6293.
[128] H. Vedder, H. U. Affolter and U. Otten, “Nerve Growth Factor (NGF) Regulates Tachykinin Gene Expression and Biosynthesis in Rat Sensory Neurons during Early Postnatal Development,” Neuropeptides, Vol. 24, No. 6, 1993, pp. 351-7.
[129] P. Holzer, “Neurogenic Vasodilatation and Plasma Leakage in the Skin,” General Pharmacology, Vol. 30, No. 1, 1998, pp. 5-11.
[130] F. Birklein, M. Schmelz, S. Schifter and M. Weber, “The Important Role of Neuropeptides in Complex Regional Pain Syndrome,” Neurology, Vol. 57, No. 12, 2001, pp. 2179-2184.
[131] C. Schinkel, A. Gaertner, J. Zaspel, S. Zedler, E. Faist and M. Schuermann, “Inflammatory Mediators Are Altered in the Acute Phase of Posttraumatic Complex Regional Pain Syndrome,” The Clinical Journal of Pain, Vol. 22, No. 3, 2006, pp. 235-239. doi:10.1097/01.ajp.0000169669.70523.f0
[132] S. Leis, M. Weber, A. Isselmann, M. Schmelz and F. Birklein, “Substance-P-Induced Protein Extravasation Is Bilaterally Increased in Complex Regional Pain Syndrome,” Experimental Neurology, Vol. 183, No. 1, 2003, pp. 197-204.
[133] S. Leis, M. Weber, M. Schmelz and F. Birklein, “Facilitated Neurogenic Inflammation in Unaffected Limbs of Patients with Complex Regional Pain Syndrome,” Neuroscience Letters, Vol. 359, No. 3, 2004, pp. 163-166. doi:10.1016/j.neulet.2004.02.025
[134] M. Weber, F. Birklein, B. Neundorfer and M. Schmelz, “Facilitated Neurogenic Inflammation in Complex Regional Pain Syndrome,” Pain, Vol. 91, No. 3, 2001, pp. 251-257.
[135] A. Dallos, M. Kiss, H. Polyanka, A. Dobozy, L. Kemeny and S. Husz, “Effects of the Neuropeptides Substance P, Calcitonin Gene-Related Peptide, Vasoactive Intestinal Polypeptide and Galanin on the Production of Nerve Growth Factor and Inflammatory Cytokines in Cultured Human Keratinocytes,” Neuropeptides, Vol. 40, No. 4, 2006, pp. 251-263. doi:10.1016/j.npep.2006.06.002
[136] W. S. Kingery, “Role of Neuropeptide, Cytokine, and Growth Factor Signaling in Complex Regional Pain Syndrome,” Pain Medicine, Vol. 11, No. 8, 2010, pp. 1239-1250. doi:10.1111/j.1526-4637.2010.00913.x
[137] F. Wesseldijk, F. J. Huygen, C. Heijmans-Antonissen, S. P. Niehof and F. J. Zijlstra, “Tumor Necrosis Factor-Alpha and Interleukin-6 Are Not Correlated with the Characteristics of Complex Regional Pain Syndrome Type 1 in 66 Patients,” European Journal of Pain, Vol. 12, No. 6, 2008, pp. 716-721. doi:10.1016/j.ejpain.2007.10.010
[138] C. Maihofner, H. O. Handwerker, B. Neundorfer and F. Birklein, “Mechanical Hyperalgesia in Complex Regional Pain Syndrome: A Role for TNF-Alpha?” Neurology, Vol. 65, No. 2, 2005, pp. 311-313. doi:10.1212/01.wnl.0000168866.62086.8f
[139] R. J. Schwartzman, G. M. Alexander, J. Grothusen, “The Use of Ketamine in Complex Regional Pain Syndrome: Possible Mechanisms,” Expert Review of Neurotherapeutics, Vol. 11, No. 5, 2011, pp. 719-734.
[140] N. M. Hulsman, J. H. Geertzen, P. U. Dijkstra, J. J. van den Dungen and W. F. den Dunnen, “Myopathy in CRPS- I: Disuse or Neurogenic?” European Journal of Pain, Vol. 13, No. 7, 2009, pp. 731-736. doi:10.1016/j.ejpain.2008.09.006
[141] T. Klimova and N. S. Chandel, “Mitochondrial Complex III Regulates Hypoxic Activation of HIF,” Cell Death and Differentiation, Vol. 15, No. 4, 2008, pp. 660-666. doi:10.1038/sj.cdd.4402307
[142] A. Heerschap, J. A. den Hollander, H. Reynen and R. J. Goris, “Metabolic Changes in Reflex Sympathetic Dystrophy: A 31P NMR Spectroscopy Study,” Muscle Nerve, Vol. 16, No. 4, 1993, pp. 367-373. doi:10.1002/mus.880160405
[143] T. L. Clanton, “Hypoxia-Induced Reactive Oxygen Species Formation in Skeletal Muscle,” Journal of Applied Physiology, Vol. 102, No. 6, 2007, pp. 2379-2388. doi:10.1152/japplphysiol.01298.2006
[144] E. C. Tan, H. J. Ter Laak, M. T. Hopman, H. van Goor and R. J. Goris, “Impaired Oxygen Utilization in Skeletal Muscle of CRPS I Patients,” Journal of Surgical Research, Vol. 173, No. 1, 2012, pp. 145-152. doi:10.1016/j.jss.2010.08.043
[145] E. C. Tan, A. J. Janssen, P. Roestenberg, L. P. van den Heuvel, R. J. Goris and R. J. Rodenburg, “Mitochondrial Dysfunction in Muscle Tissue of Complex Regional Pain Syndrome Type I Patients,” European Journal of Pain, Vol. 15, No. 7, 2011, pp. 708-715. doi:10.1016/j.ejpain.2010.12.003
[146] K. B. Choksi, W. H. Boylston, J. P. Rabek, W. R. Widger and J. Papaconstantinou, “Oxidatively Damaged Proteins of Heart Mitochondrial Electron Transport Complexes,” Biochimica et Biophysica Acta, Vol. 1688, No. 2, 2004, pp. 95-101. doi:10.1016/j.bbadis.2003.11.007
[147] E. Eisenberg, S. Shtahl, R. Geller, A. Z. Reznick, O. Sharf, M. Ravbinovich, et al., “Serum and Salivary Oxidative Analysis in Complex Regional Pain Syndrome,” Pain, Vol. 138, No. 1, 2008, pp. 226-232. doi:10.1016/j.pain.2008.04.019
[148] R. S. Perez, W. W. Zuurmond, P. D. Bezemer, D. J. Kuik, van A. C. Loenen, J. J. de Lange, et al., “The Treatment of Complex Regional Pain Syndrome Type I with Free Radical Scavengers: A Randomized Controlled Study,” Pain, Vol. 102, No. 3, 2003, pp. 297-307.
[149] L. van der Laan, H. J. ter Laak, A. Gabreels-Festen, F. Gabreels and R. J. Goris, “Complex Regional Pain Syndrome Type I (RSD): Pathology of Skeletal Muscle and Peripheral nerve,” Neurology, Vol. 51, No. 1, 1998, pp. 20-25.
[150] T. Higashimoto, E. E. Baldwin, J. I. Gold and R. G. Boles, “Reflex Sympathetic Dystrophy: Complex Regional Pain Syndrome Type I in Children with Mitochondrial Disease and Maternal Inheritance,” Archives of Disease in Childhood, Vol. 93, No. 5, 2008, pp. 390-397. doi:10.1136/adc.2007.123661
[151] F. Kozin, H. K. Genant, C. Bekerman and D. J. McCarty, “The Reflex Sympathetic Dystrophy Syndrome. II. Roentgenographic and Scintigraphic Evidence of Bilaterality and of Periarticular Accentuation,” American Journal of Medicine, Vol. 60, No. 3, 1976, pp. 332-338.
[152] W. S. Kingery, S. C. Offley, T. Z. Guo, M. F. Davies, J. D. Clark, C. R. Jacobs, “A Substance P Receptor (NK1) Antagonist Enhances the Widespread Osteoporotic Effects of Sciatic Nerve Section,” Bone, Vol. 33, No. 6, 2003, pp. 927-936.
[153] M. E. Schweitzer, S. Mandel, R. J. Schwartzman, R. L. Knobler and A. J. Tahmoush, “Reflex Sympathetic Dystrophy Revisited: MR Imaging Findings before and after Infusion of Contrast Material,” Radiology, Vol. 195, No. 1, 1995, pp. 211-214.
[154] M. Hukkanen, Y. T. Konttinen, S. Santavirta, P. Paavolainen, X. H. Gu, G. Terenghi, et al., “Rapid Proliferation of Calcitonin Gene-Related Peptide-Immunoreactive Nerves during Healing of Rat Tibial Fracture Suggests Neural Involvement in Bone Growth and Remodelling,” Neuroscience, Vol. 54, No. 4, 1993, pp. 969-979.
[155] S. C. Offley, T. Z. Guo, T. Wei, J. D. Clark, H. Vogel, D. P. Lindsey, et al., “Capsaicin-Sensitive Sensory Neurons Contribute to the Maintenance of Trabecular Bone Integrity,” Journal of Bone and Mineral Research, Vol. 20, No. 2, 2005, pp. 257-267. doi:10.1359/JBMR.041108
[156] S. Santavirta, Y. T. Konttinen, D. Nordstrom, A. Makela, T. Sorsa, M. Hukkanen, et al., “Immunologic Studies of Nonunited Fractures,” Acta Orthopaedica Scandinavica, Vol. 63, No. 6, 1992, pp. 579-586.
[157] M. E. Fundytus, K. Yashpal, J. G. Chabot, M. G. Osborne, C. D. Lefebvre, A. Dray, et al., “Knockdown of Spinal Metabotropic Glutamate Receptor 1 (mGluR(1)) Alleviates Pain and Restores Opioid Efficacy after Nerve Injury in Rats,” British Journal of Pharmacology, Vol. 132, No. 1, 2001, pp. 354-367. doi:10.1038/sj.bjp.0703810
[158] R. Schwartzman and P. Ambady, “Tertiary Adrenal Insufficiency in CRPS: Effects of Chronic Pain on the Hypothalamic-Pituitary-Adrenal Axis,” Unpublished.
[159] M. Shibata, T. Ohkubo, H. Takahashi and R. Inoki, “Modified Formalin Test: Characteristic Biphasic Pain Response,” Pain, Vol. 38, No. 3, 1989, pp. 347-352.
[160] H. Logan, S. Lutgendorf, P. Rainville, D. Sheffield, K. Iverson and D. Lubaroff, “Effects of Stress and Relaxation on Capsaicin-Induced Pain,” Journal of Pain, Vol. 2, No. 3, 2001, pp. 160-170. doi:10.1054/jpai.2001.21597
[161] A. Tjolsen, O. G. Berge, S. Hunskaar, J. H. Rosland, K. Hole, “The Formalin Test: An Evaluation of the Method,” Pain, Vol. 51, No. 1, 1992, pp. 5-17.
[162] W. Xie, X. Liu, H. Xuan, S. Luo, X. Zhao, Z. Zhou, et al., “Effect of Betamethasone on Neuropathic Pain and Cerebral Expression of NF-Kappab and Cytokines,” Neuroscience Letters, Vol. 393, No. 2-3, 2006, pp. 255-259. doi:10.1016/j.neulet.2005.09.077
[163] J. D. Croxtall, Q. Choudhury and R. J. Flower, “Glucocorticoids Act within Minutes to Inhibit Recruitment of Signalling Factors to Activated EGF Receptors through a Receptor-Dependent, Transcription-Independent Mechanism,” British Journal of Pharmacology, Vol. 130, No. 2, 2000, pp. 289-298. doi:10.1038/sj.bjp.0703272
[164] M. Devor, R. Govrin-Lippmann and P. Raber, “Corticosteroids Suppress Ectopic Neural Discharge Originating in Experimental Neuromas,” Pain, Vol. 22, No. 2, 1985, pp. 127-37.
[165] A. Johansson, J. Hao, B. Sjolund, “Local Corticosteroid Application Blocks Transmission in Normal Nociceptive C-Fibres,” Acta Orthopaedica Scandinavica, Vol. 34, No. 5, 1990, pp. 335-338.
[166] M. Qin, J. J. Wang, R. Cao, H. Zhang, L. Duan, B. Gao, et al., “The Lumbar Spinal Cord Glial Cells Actively Modulate Subcutaneous Formalin Induced Hyperalgesia in the Rat,” Neuroscience Research, Vol. 55, No. 4, 2006, pp. 442-450. doi:10.1016/j.neures.2006.04.017
[167] S. Hisano, S. Li, Y. Kagotani and S. Daikoku, “Synaptic Associations between Oxytocin-Containing Magnocellular Neurons and Neurons Containing Corticotropin-Releasing Factor in the Rat Magnocellular Paraventricular Nucleus,” Brain Research, Vol. 576, No. 2, 1992, pp. 311-318.
[168] M. C. Levin and P. E. Sawchenko, “Neuropeptide Co-Expression in the Magnocellular Neurosecretory System of the Female Rat: Evidence for Differential Modulation by Estrogen,” Neuroscience, Vol. 54, No. 4, 1993, pp. 1001-1018.
[169] A. Rhodin, M. Stridsberg and T. Gordh, “Opioid Endocrinopathy: A Clinical Problem in Patients with Chronic Pain and Long-Term Oral Opioid Treatment,” Clinical Journal of Pain, Vol. 26, No. 5, 2010, pp. 374-380. doi:10.1097/AJP.0b013e3181d1059d
[170] G. F. Webster, R. V. Iozzo, R. J. Schwartzman, A. J. Tahmoush, R. L. Knobler and R. A. Jacoby, “Reflex Sympathetic Dystrophy: Occurrence of Chronic Edema and Nonimmune Bullous Skin Lesions,” Journal of the American Academy of Dermatology, Vol. 28, No. 1, 1993, pp. 29-32.
[171] M. Milea, H. A. Dimov and B. Cribier, “Generalized Schamberg’s Disease Treated with PUVA in a Child,” Annales De Dermatologie Et De Venereologie, Vol. 134, No. 4, 2007, pp. 378-380.
[172] J. E. Bernstein, M. Medenica, K. Soltani and S. F. Griem, “Bullous Eruption of Diabetes Mellitus,” Archives of Dermatology, Vol. 115, No. 3, 1979, pp. 324-325.
[173] J. Toonstra, “Bullosis Diabeticorum. Report of a Case with a Review of the Literature,” Journal of the American Academy of Dermatology, Vol. 13, No. 5, 1985, pp. 799- 805.
[174] A. Kurwa, P. Roberts and R. Whitehead, “Concurrence of Bullous and Atrophic Skin Lesions in Diabetes Mellitus,” Archives of Dermatology, Vol. 103, No. 6, 1971, pp. 670- 675.
[175] P. J. Albrecht, S. Hines, E. Eisenberg, D. Pud, D. R. Finlay, M. K. Connolly, et al., “Pathologic Alterations of Cutaneous Innervation and Vasculature in Affected Limbs from Patients with Complex Regional Pain Syndrome,” Pain, Vol. 120, No. 3, 2006, pp. 244-266. doi:10.1016/j.pain.2005.10.035
[176] A. L. Oaklander, J. G. Rissmiller, L. B. Gelman, L. Zheng, Y. Chang and R. Gott, “Evidence of Focal Small- Fiber Axonal Degeneration in Complex Regional Pain Syndrome-I (Reflex Sympathetic Dystrophy),” Pain, Vol. 120, No. 3, 2006, pp. 235-243. doi:10.1016/j.pain.2005.09.036
[177] S. Kharkar, Y. Venkatesh, J. Grothusen, L. Rojas and R. J. Schwartzman, “Skin Biopsy in Chronic Regional Pain Syndrome: Case Series and Literature Review,” Pain Physician, Vol. 15, No. 3, 2012, pp. 255-266.
[178] P. D. Drummond, P. M. Finch and I. Gibbins, “Innervation of Hyperalgesic Skin in Patients with Complex Regional Pain Syndrome,” Clinical Journal of Pain, Vol. 12, No. 3, 1996, pp. 222-231.
[179] S. T. Hsieh and W. M. Lin, “Modulation of Keratinocyte Proliferation by Skin Innervation,” Journal of Investigative Dermatology, Vol. 113, No. 4, 1999, pp. 579-586. doi:10.1046/j.1523-1747.1999.00737.x
[180] C. A. Maggi, F. Borsini, P. Santicioli, P. Geppetti, L. Abelli, S. Evangelista, et al., “Cutaneous Lesions in Capsaicin-Pretreated Rats. A Trophic Role of Capsaicin-Sensitive Afferents?” Naunyn Schmiedebergs Arch Pharmacology, Vol. 336, No. 5, 1987, pp. 538-545.
[181] P. Sandroni, P. A. Low, T. Ferrer, T. L. Opfer-Gehrking, C. L. Willner and P. R. Wilson, “Complex Regional Pain Syndrome I (CRPS I): Prospective Study and Laboratory Evaluation,” Clinical Journal of Pain, Vol. 14, No. 4, 1998, pp. 282-289.
[182] F. H. Gardner and L. K. Diamond, “Autoerythrocyte Sensitization; a Form of Purpura Producing Painful Bruising Following Autosensitization to Red Blood Cells in Certain Women,” Blood, Vol. 10, No. 7, 1955, pp. 675-690.
[183] O. L. Ivanov, A. N. Lvov, A. V. Michenko, J. Kunzel, P. Mayser and U. Gieler, “Autoerythrocyte Sensitization Syndrome (Gardner-Diamond Syndrome): Review of the Literature,” Journal of the European Academy of Dermatology and Venereology, Vol. 23, No. 5, 2009, pp. 499- 504. doi:10.1111/j.1468-3083.2009.03096.x
[184] D. Cansu, T. Kasifoglu, O. Pasaoglu and C. Korkmaz, “Autoerythrocyte Sensitization Syndrome (Gardner- Diamond Syndrome) Associated with Cutaneous Vasculitis,” Joint Bone Spine, Vol. 75, No. 6, 2008, pp. 721-724. doi:10.1016/j.jbspin.2007.10.007
[185] A. Strunecka, L. Krpejsova, J. Palecek, J. Macha, M. Maturova, L. Rosa, et al., “Transbilayer Redistribution of Phosphatidylserine in Erythrocytes of a Patient with Autoerythrocyte Sensitization Syndrome (Psychogenic purpura),” Folia Haematol Int Mag Klin Morphol Blutforsch, Vol. 117, No. 6, 1990, pp. 829-841.
[186] F. Birklein, “Complex Regional Pain Syndrome,” Journal of Neurology, Vol. 252, No. 2, 2005, pp. 131-138. doi:10.1007/s00415-005-0737-8
[187] J. Marinus, G. L. Moseley, F. Birklein, R. Baron, C. Maihofner, W. S. Kingery, et al., “Clinical Features and Pathophysiology of Complex Regional Pain Syndrome,” Lancet Neurology, Vol. 10, No. 7, 2011, pp. 637-648. doi:10.1016/S1474-4422(11)70106-5
[188] M. B. Chancellor, P. J. Shenot, D. A. Rivas, S. Mandel and R. J. Schwartzman, “Urological Symptomatology in Patients with Reflex Sympathetic Dystrophy,” Journal of Urology, Vol. 155, No. 2, 1996, pp. 634-637.
[189] J. E. Chalkley, C. Lander and J. C. Rowlingson, “Probable Reflex Sympathetic Dystrophy of the Penis,” Pain, Vol. 25, No. 2, 1986, pp. 223-225.
[190] W. L. Olson, “Perineal Reflex Sympathetic Dystrophy Treated with Bilateral Lumbar Sympathectomy,” Annals of Internal Medicine, Vol. 113, No. 8, 1990, pp. 633-634.
[191] D. J. Libon, M. W. Bondi, C. C. Price, M. Lamar, J. Ep-pig, D. M. Wambach, et al., “Verbal Serial List Learning in Mild Cognitive Impairment: A Profile Analysis of Interference, Forgetting, and Errors,” Journal of the International Neuropsychological Society: JINS, Vol. 17, No. 5, 2011, pp. 905-914. doi:10.1017/S1355617711000944
[192] M. B. Yunus, “The Prevalence of Fibromyalgia in Other Chronic Pain Conditions,” Pain Research and Treatment, Vol. 2012, No. 2012, Article ID: 584573. doi:10.1155/2012/584573
[193] B. L. Loevinger, D. Muller, C. Alonso and C. L. Coe, “Metabolic Syndrome in Women with Chronic Pain,” Metabolism, Vol. 56, No. 1, 2007, pp. 87-93. doi:10.1016/j.metabol.2006.09.001
[194] S. C. T. Safder, E. Heller and G. Chelimsky, “Non- Psychiatric Co-Morbidities in Pediatric Functional Gastrointestinal Disorder (FGID): An Area in Need of Exploration,” Clinical Autonomic Research, Vol. 18, No. 5, 2008, pp. 241-87.
[195] G. Chelimsky, S. Madan, A. Alshekhlee, E. Heller, K. McNeeley and T. Chelimsky, “A Comparison of Dysautonomias Comorbid with Cyclic Vomiting Syndrome and with Migraine,” Gastroenterology Research and Practice, Vol. 2009, No. 2009, Article ID: 701019. doi:10.1155/2009/701019
[196] C. Quattrini, M. Jeziorska and R. A. Malik, “Small Fiber Neuropathy in Diabetes: Clinical Consequence and Assessment,” The International Journal of Lower Extremity Wounds, Vol. 3, No. 1, 2004, pp. 16-21. doi:10.1177/1534734603262483
[197] S. E. Lakhan and A. Kirchgessner, “Gut Inflammation in Chronic Fatigue Syndrome,” Nutrition & Metabolism, Vol. 7, No. 2010, p. 79. doi:10.1186/1743-7075-7-79
[198] M. Costigan, J. Scholz and C. J. Woolf, “Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage,” Annual Review of Neuroscience, Vol. 32, No. 2009, pp. 1-32. doi:10.1146/annurev.neuro.051508.135531

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