Department of Algology, Ankara Training and Research Hospital, Altındağ, Ankara, Turkey.
Department of Neurology, Ankara Training and Research Hospital, Altındağ, Ankara, Turkey.
Pain Pract. 2023 Jul;23(6):603-608. doi: 10.1111/papr.13222. Epub 2023 Mar 20.
Complex regional pain syndrome (CRPS) can be distinguished as type I without and type II with electrophysiological evidence of major nerve lesion. The pathophysiology of both subgroups is still under investigation. The aim of this research is to demonstrate the nerve morphology and electrophysiology in CRPS type I patients.
Bilateral median and ulnar nerve cross-sectional areas were evaluated with ultrasound and also median and ulnar nerve conduction studies of both hands were performed. Cross-sectional areas of median and ulnar nerves and nerve conduction studies in healthy controls were also obtained and compared with the patients.
Twenty-five male patients and 11 healthy male controls were enrolled in the study. The mean age of the patients was 24.08 ± 5.50 years and controls was 23.18 ± 5.09 (p > 0.05). Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the diseased side were found significantly lower than the healthy side (p < 0.05). Both median and ulnar nerve distal motor latency values were significantly higher in the patient group (p < 0.05). There was no significant difference in the median and ulnar nerve cross-sectional area when compared with the opposite extremity and healthy volunteers.
The lower SNAP and CMAP amplitudes of the median and ulnar nerves compared to the healthy side and the prolongation of the affected side median and ulnar nerve distal motor latencies of the affected individuals may indicate axonal involvement in patients with CRPS type 1. Decreased CMAP amplitudes may also indicate muscle atrophy due to a decrease in the number of functional motor units.
复杂性区域疼痛综合征（CRPS）可分为无电生理证据的Ⅰ型和有证据的Ⅱ型。这两种亚组的病理生理学仍在研究中。本研究旨在展示 CRPS Ⅰ型患者的神经形态和电生理学特征。
使用超声评估双侧正中神经和尺神经的横截面积，并对双手的正中神经和尺神经进行神经传导研究。还获得了健康对照组的正中神经和尺神经横截面积和神经传导研究数据，并与患者进行了比较。
研究纳入 25 名男性患者和 11 名健康男性对照。患者的平均年龄为 24.08±5.50 岁，对照组为 23.18±5.09 岁（p>0.05）。患侧的复合肌肉动作电位（CMAP）和感觉神经动作电位（SNAP）振幅明显低于健侧（p<0.05）。患者组正中神经和尺神经的远端运动潜伏期均显著升高（p<0.05）。与对侧肢体和健康志愿者相比，正中神经和尺神经的横截面积无显著差异。
与健侧相比，正中神经和尺神经的 SNAP 和 CMAP 振幅较低，患侧正中神经和尺神经的远端运动潜伏期延长，这可能表明 CRPS 1 型患者存在轴索受累。CMAP 振幅降低也可能表明由于功能性运动单位数量减少而导致肌肉萎缩。
