Beer S, Kesselring J
Rheuma- und Rehabilitationszentrum, Valens.
Ther Umsch. 1998 Oct;55(10):618-23.
Pain syndromes in the lower limbs are a particular challenge for the clinical neurologist. Pain may be due to various disorders of the central and peripheral nervous system or muscles of different etiologies. There is a continuum from slightly unpleasant sensory disturbances to nociception. Differential diagnosis must be sought according to topological and pathophysiological interpretation of the clinical findings. This will determine the necessary diagnostic requirements and therapeutic procedures. Within the central nervous system lesions of the nociceptive projections of the spinal cord or brain may lead to pain in the lower limbs. Furthermore, different pathologies of the peripheral nervous system (root, plexus, peripheral nerve) or muscles can cause pain. Finally, pain syndromes are known in clinical syndromes with disturbances of the muscle tone (extrapyramidal syndromes, spasticity) and secondary to postural problems in patients with muscular dysbalance due to paralysis.
下肢疼痛综合征对临床神经科医生来说是一项特殊挑战。疼痛可能源于中枢和周围神经系统的各种疾病或不同病因的肌肉疾病。从轻微不适的感觉障碍到伤害感受存在一个连续谱。必须根据临床发现的拓扑学和病理生理学解释进行鉴别诊断。这将决定必要的诊断要求和治疗程序。在中枢神经系统内，脊髓或大脑的伤害性投射损伤可能导致下肢疼痛。此外，周围神经系统（神经根、神经丛、周围神经）或肌肉的不同病变也可引起疼痛。最后，在伴有肌张力障碍（锥体外系综合征、痉挛）的临床综合征以及继发于瘫痪导致肌肉失衡患者姿势问题的情况下，也存在疼痛综合征。
