Smertesyndrom, regionalt: Symptomer og tegn
Regionalt smertesyndrom forekommer i to former med like symptomer og tegn, men med ulik forklaring. Type 1, som tidligere ble kalt sympatisk refleksdystrofi, opptrer etter en sykdom eller skade som ikke skyldes en direkte skade mot nervene i den aktuelle armen eller leggen. Type 2, som tidligere ble kalt kausalgi, skyldes en direkte nerveskade som kan påvises ved undersøkelser. Type 1 utgjør over 90 prosent av alle tilfeller.
Smerte er det dominerende symptomet og er uforholdsmessig sterk eller langvarig i forhold til enhver utløsende hendelse. Smerten er vanligvis lokalisert til én ekstremitet, men kan noen ganger spre seg til andre deler av kroppen. Det kan også foreligge hevelse (ødem), nedsatt bevegelighet, endringer i følesansen samt hudforandringer i armen eller benet. Symptomene kan endre seg over tid, selv innenfor samme dag. Et av vilkårene for å stille diagnosen er at ingen annen diagnose bedre kan forklare symptomer og funn.
Tidligere ble dette smertesyndromet inndelt i ulike stadier, men denne beskrivelsen har man nå forlatt. Det skilles imidlertid mellom tidlig eller akutt, og sent eller kronisk regionalt smertesyndrom. Pasienter som har hatt syndromet i mindre enn 6 måneder, har et tidlig syndrom, mens de som har hatt symptomer lengre enn 6 måneder, har et sent syndrom. Jo lengre tilstanden har vart, desto større er risiko for at plagene kan bli svært langvarige.
Dette dokumentet er basert på det profesjonelle dokumentet Komplekst regionalt smertesyndrom . Referanselisten for dette dokumentet vises nedenfor
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