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Complex Regional Pain Syndrome, Type 1: Spread of symptoms and the involvement of the sympathetic nervous system

Greatorex, Fiona (2002) Complex Regional Pain Syndrome, Type 1: Spread of symptoms and the involvement of the sympathetic nervous system. Masters by Coursework thesis, Murdoch University.

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Complex Regional Pain Syndrome, Type 1 is a chronic pain syndrome that starts with damage to soft tissue or bone, usually a limb, without nerve damage. Pain, sensory disturbances, swelling, changes in limb temperature, and spread of these disturbances are some of the characteristic symptoms of the syndrome. Due to pain and symptoms patients are often distressed. Given the symptoms, it is generally accepted that the sympathetic nervous system contributes to CRPS-1, but it has not been determined whether there is a central or peripheral disturbance. Since little is known about the mechanisms of CRPS-1, treatment options are limited. Seventeen participants with CRPS-1 were assessed for skin temperature, touch perception and thermal perception at 4 sites on each side of the body (all limbs, brows and cheeks). To investigate whether the disturbance of the SNS is central or in the periphery, dilation of the pupils to tyramine and phenylephrine drops in two separate sessions was examined. Photographs of the eyes were taken in light and darkness to determine dilation of the pupils to the drops. When 9 participants with spread of pain symptoms were compared with 8 participants without spread it was found that affected limbs were cooler and perception of cool was also lower for those with spread. Perception of warmth and perception of sharp at the cheeks was higher for those with spread. All participants were cooler at the affected limb, and a stimulus was perceived as sharper at the affected limb and on the affected side of the brow. These results give some indication of a central disturbance. Tyramine and phenylephrine both dilated pupils, but there was no difference between sides to either drops. Although no systematic asymmetry was noted, during testing it was observed that disturbances were sometimes on the unaffected side. No conclusions as to whether the disturbance of the sympathetic nervous system is central or in the periphery can be reached from the results. Further investigations need to be undertaken with larger samples and control groups.

Item Type: Thesis (Masters by Coursework)
Murdoch Affiliation(s): School of Psychology
Notes: Note to the author: If you would like to make your thesis openly available on Murdoch University Library's Research Repository, please contact: Thank you.
Supervisor(s): Drummond, Peter
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