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Rheumatology Advance Access originally published online on April 16, 2003
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Rheumatology 2003; 42: 1067-1073
© 2003 British Society for Rheumatology

Referred sensations in patients with complex regional pain syndrome type 1

C. S. McCabe, R. C. Haigh, P. W. Halligan1 and D. R. Blake

The Royal National Hospital for Rheumatic Diseases, in conjunction with The Department of Medical Sciences and The Department of Pharmacy and Pharmacology, University of Bath, Bath BA1 1RL and
1 School of Psychology, Cardiff University, PO Box 901, Cardiff CF10 3YG, UK

Objectives. This study sought to explore and characterize referred sensations (RS) in patients with complex regional pain syndrome (CRPS) type 1 and test the hypothesis that pain in CRPS is associated with central sensory changes.

Methods. Subjects underwent standardized neurological examination involving light touch, pinprick and vibration sense with eyes closed and then with eyes open. The subjects described the location and sensation emanating from the stimulated site and whether they experienced any sensations (similar or different) elsewhere.

Results. Five of 16 subjects recruited demonstrated RS. These were experienced in real time, were modality specific (touch and pinprick) and were located on the body part immediately adjacent, on Penfield's cortical homunculus, to the stimulated site. The RS were diminished or absent when the subject visualized the stimulated area. They disappeared when stimulation ceased and on clinical improvement.

Conclusions. This is the first report of RS in CRPS and provides further evidence of central reorganization in what was previously thought to be a peripheral disorder.

KEY WORDS: Complex regional pain syndrome type 1, Referred sensations, Central reorganization.

Correspondence to: C. S. McCabe, The Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. E-mail: candy.mccabe{at}rnhrd-tr.swest.nhs.uk


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