Grothusen John R, Alexander Guillermo, Erwin Kirsten, Schwartzman Robert
Drexel University College of Medicine, Philadelphia, PA.
Pain Physician. 2014 Jan-Feb;17(1):71-9.
Quantitative sensory testing (QST), with thermal threshold determinations, is a routine part of the comprehensive clinical workup of patients suffering from chronic pain, especially those with Complex Regional Pain Syndrome seen at our outpatient pain clinic. This is done to quantitatively assess each patient's small fiber and sensory function in a controlled manner. Most patients have normal sensory detection thresholds, but there are large differences in thermal pain thresholds. Some patients display no thermal hyperalgesia, while other patients display severe thermal hyperalgesia when tested in all 4 limbs.
To ascertain the prevalence of thermal hyperalgesia in patients with complex regional pain syndrome type 1 (CRPS-I).
This was a retrospective review of the results of QST performed on 105 patients as part of their clinical workup.
The outpatient clinic of the Department of Neurology at Drexel University College of Medicine.
All patients had a diagnosis of CRPS-I. Thermal quantitative sensory testing, including cool detection, warm detection, cold pain, and heat pain, was performed on 8 distal sites on each patient as part of a comprehensive clinical examination.
With regards to thermal hyperalgesia, patients with CPRS-I appear to fall into distinct groups. One subgroup displays evidence of generalized cold and heat hyperalgesia, one subgroup displays evidence of generalized cold hyperalgesia only, one displays evidence of heat hyperalgesia only, and one subgroup does not display evidence of cold or heat hyperalgesia.
This study is based on retrospective information on a relatively small (105 patient records) number of patients. Since only patients with CRPS-I were included, the results are only applicable to this group.
Thermal QST provides useful information about the sensory phenotype of individual patients. Subgrouping based on thermal hyperalgesia may be useful for future studies regarding prognosis, treatment selection, and efficacy.
定量感觉测试（QST）以及热阈值测定是慢性疼痛患者，尤其是在我们门诊疼痛诊所就诊的复杂性区域疼痛综合征患者全面临床检查的常规组成部分。这样做是为了以可控方式定量评估每位患者的小纤维和感觉功能。大多数患者的感觉检测阈值正常，但热痛阈值存在很大差异。一些患者未表现出热痛觉过敏，而其他患者在对所有四肢进行测试时则表现出严重的热痛觉过敏。
确定1型复杂性区域疼痛综合征（CRPS-I）患者中热痛觉过敏的患病率。
这是一项对105例患者进行QST结果的回顾性研究，该研究作为他们临床检查的一部分。
德雷塞尔大学医学院神经科门诊。
所有患者均诊断为CRPS-I。作为全面临床检查的一部分，对每位患者的8个远端部位进行热定量感觉测试，包括冷觉检测、温觉检测、冷痛和热痛。
关于热痛觉过敏，CRPS-I患者似乎可分为不同组。一个亚组表现出全身性冷热痛觉过敏的证据，一个亚组仅表现出全身性冷痛觉过敏的证据，一个亚组仅表现出热痛觉过敏的证据，还有一个亚组未表现出冷或热痛觉过敏的证据。
本研究基于相对较少（105份患者记录）患者的回顾性信息。由于仅纳入了CRPS-I患者，结果仅适用于该组。
热QST为个体患者的感觉表型提供了有用信息。基于热痛觉过敏进行亚组划分可能对未来关于预后、治疗选择和疗效的研究有用。
