Rheumatology Advance Access published online on April 16, 2003
Rheumatology, doi:10.1093/rheumatology/keg298
Rheumatology © British Society for Rheumatology 2003; all rights reserved
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Original Papers
1 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
* Corresponding author. E-mail: candy.mccabe{at}rnhrd-tr.swest.nhs.uk.
Received 17 October 2002
; accepted 5 February 2003
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.
Referred sensations in patients with complex regional pain syndrome type 1
2 School of Psychology, Cardiff University, PO Box 901, Cardiff CF10 3YG, UK
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