Review
Nosological entities?
Reflex sympathetic dystrophy
G D SchottPain Management
Department, National Hospital for Neurology and Neurosurgery, Queen
Square, London WC1N 3BG, UK geoffrey.schott@uclh.org
Received 29 August
2000 and in revised form 13 February 2001;
Accepted 16
February 2001
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Does reflex sympathetic dystrophy (RSD) exist? If it does, how is it defined, what is its nature, and how is it treated? Reviewed on many occasions,1-4 the subject engenders considerable and often heated debate. Some of the reasons for the continuing debate are summarised in this discussion.
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The question of definition |
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HOW DID WE REACH THE PRESENT SITUATION?
In 1864 Silas Weir Mitchell, a founding father of American
neurology, together with Morehouse and Keen, described the clinical condition of causalgia in soldiers injured in the American civil war.5 This term, which means burning pain, was used to
describe a particular painful condition that sometimes followed major
nerve injury. The nerve injury, which was usually partial, typically affected a limb. The burning pain was often accompanied by additional features including various sensory disturbances; temperature and sweating changes; glossy and other disturbances of the skin,
subcutaneous tissues, muscles and joints; paralysis; and involuntary movements.
Earlier this century,
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