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化疗引起的周围神经病变是否属于复杂性区域疼痛综合征范畴?一项叙述性综述。

Does Chemotherapy-Induced Peripheral Neuropathy Fall Within the Spectrum of Complex Regional Pain Syndrome? A Narrative Review.

作者信息

Malik Aila, Javed Saba

机构信息

Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX, USA.

Department of Pain Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.

出版信息

Curr Pain Headache Rep. 2025 Apr 21;29(1):77. doi: 10.1007/s11916-025-01390-3.

Abstract

PURPOSE OF REVIEW

Peripheral neuropathies and complex regional pain syndrome (CRPS) result in a similar clinical picture including shared sudomotor and vasomotor symptomatology. Chemotherapeutic agents can precipitate chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients akin to development of CRPS following trauma. Below we review the areas of overlap between CRPS and CIPN including their shared pathophysiology, clinical presentation, diagnostics, and treatment options.

RECENT FINDINGS

The features of autonomic dysfunction, motor impairment, and reduced proprioception observed in both CRPS and CIPN may result from shared mechanisms include inflammatory reactions, immune dysregulation, autonomic changes, as well as central and peripheral sensitization. Both conditions are a clinical diagnosis of exclusion, and demand a personalized, multidisciplinary therapeutic approach inclusive of psychosocial interventions to reduce deleterious effects on an individual's quality of life. CIPN is recognized as a separate clinical entity albeit sharing a similar underlying pathology and clinical presentation with CRPS. It may be plausible to include CIPN on the CRPS clinical spectrum as our mechanistic understanding of its development and progression evolves.

摘要

综述目的

周围神经病变和复杂性区域疼痛综合征(CRPS)会导致相似的临床表现,包括共同的汗腺运动和血管运动症状。化疗药物可使癌症患者发生化疗引起的周围神经病变(CIPN),类似于创伤后发生CRPS。下面我们综述CRPS和CIPN之间的重叠领域,包括它们共同的病理生理学、临床表现、诊断和治疗选择。

最新发现

在CRPS和CIPN中观察到的自主神经功能障碍、运动障碍和本体感觉减退的特征,可能源于共同的机制,包括炎症反应、免疫失调、自主神经变化以及中枢和外周敏化。这两种情况均为排除性临床诊断,需要个性化的多学科治疗方法,包括心理社会干预,以减少对个体生活质量的有害影响。CIPN被认为是一种独立的临床实体,尽管与CRPS有相似的潜在病理和临床表现。随着我们对其发生和发展机制的理解不断深入,将CIPN纳入CRPS临床谱可能是合理的。

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