Reflex sympathetic dystrophy (RSD), recently reclassified as a complex regional pain syndrome, type I (CRPS-I), is best known for its disabling sensory symptoms, including pain, allodynia, and abnormal skin temperature. Yet, motor dysfunction is common in CRPS and can result in major disability. In addition to weakness of the involved limb, CRPS patients may develop symptoms akin to a neurological neglect-like syndrome, whereby the limb may feel foreign ("cognitive neglect") and directed mental and visual attention is needed to move the limb ("motor neglect"). Members of the patient support group, the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA), were mailed a questionnaire inserted in their newsletter which inquired about the presence of these neglect-like symptoms; in addition, a separate medical history questionnaire was included to assess adequate documentation for the diagnosis of CRPS. A total of 242 patients returned the questionnaire but only 224 of the questionnaires were analyzed; 15 were excluded due to inadequate documentation of CRPS and 3 were excluded due to non-limb involvement. Eighty-four percent (84%) of these respondents endorsed the presence of at least one neglect symptom and 47% indicated they had both "cognitive" and "motor" neglect symptoms. Of interest, approximately 33% of respondents spontaneously wrote comments regarding the significant disability due to these neglect symptoms and the difficulty explaining these unusual symptoms to their health care providers and family. This patient survey confirms the presence of neglect-like symptoms in a subset of CRPS patients. Neglect-like symptoms need to be addressed and validated by health care providers.
この論文は、CRPS患者での運動問題を初めて質問紙調査を行った研究。
この論文でのCRPS患者に行った質問。
当てはまる以下の項目にチェックをつけてください。
①痛みのある患肢は、注意を向けなければ動かない。（motor neglect）
②痛みのある患肢は、体の一部のように感じない。 (cognitive neglect)
③痛みのある患肢を思い通りに動かそうとするときは、全力で注意を向けなければならない。 (motor neglect)
④痛みのある患肢は、時々動かそうとしてないないのに勝手に動く。(motor neglect)
⑤痛みのある患肢は、壊死してしまったように感じる。(cognitive neglect)
（結果）
質問４の２２４名のCRPS患者の回答
◯８４％ ４問中１問でも該当すると答えた患者数
◯４７％ ②と③両方の項目で該当すると答えた患者
◯６０％ ②が該当すると答えた患者
◯５６％ ③が該当すると答えた患者
◯４２％ ①が該当すると答えた患者
◯３９％ ⑤が該当すると答えた患者
◯６８％ ④に該当すると答えた患者
かなりの数のCRPS患者が運動的側面にも問題があることを訴えていることが明らかになった。
0 件のコメント:
コメントを投稿