Article

Poststroke Complex Regional Pain Syndrome (CRPS) affects a significant number of
moderate to severely impaired stroke survivors. Until recently, advances in the
assessment and management of CRPS have been limited due to the lack of a
consensus on diagnostic criteria; however, with the development of the
International Association for the Study of Pain diagnostic criteria, the medical
and scientific communities are poised to make significant strides. Biomechanical
factors and microtrauma to the hemiparetic shoulder may have a significant role
in the genesis of CPRS, although the exact pathophysiology that links these
triggers to the observed disease manifestation remains uncertain. Sympathetic
dysfunction has historical importance in the CRPS literature. However, this
appears to be only one of several possible pathophysiologic mechanisms; somatic
nervous system dysfunction, inflammation, hypoxia, and psychological factors are
also likely contributors to the disease process. There is no definitive treatment
for CRPS, and most patients are treated empirically. Nevertheless, there is
consensus that the treatment approach should be interdisciplinary with the goals
of edema and pain control, maintenance of joint and muscle biomechanics, and
functional restoration. As more rigorous clinical trials emerge, the treatment
approach will become more rational with selection of interventions based on a
specific mechanism or a combination of mechanisms responsible for a given
individual's disease manifestation.

Langue : ANGLAIS