Causalgia-dystonia Syndrome

J Korean Neurol Assoc > Volume 14(3); 1996 > Article

Journal of the Korean Neurological Association 1996;14(3): 861-867.

작열통-근긴장이상 증후군

김원찬, 이명식

영동 세브란스병원 신경과, 연세 뇌 연구소 연세대학교 의과대학

Causalgia-dystonia Syndrome

W.C. Kim, M.D., M.S., Lee, Lee M.D.

Department of neurology, Yongdong Severance Hospital, Brain Research Center, Yonsei University College of Medicine

Abstract

Most movement disorders are caused by the dysfunction of central nervous system, but sometimes involuntary movements may occur as a consequence of peripheral trauma, Patients with hemifacial spasm, segmental myoclonus, edentulous orodyskinesias, amputation stump dyskinesias, tremor and dystonia after peripheral trauma have been reported. Limb dystonia following peripheral trauma has received much renewed interest in recent years. In some patients with limb dystonia associated with peripheral trauma, causalgia or reflex sympathetic dystrophy (RSD) can be accompanied. We report a 70 year-old man who developed painful dystonic muscle spasms in the right hand after a severe injury to the right forearm. Burning pain and signs of sympathetic overactivity were accompanied. Electrophysiologic study showed a complete lesion of the right median nerve. A thermography study revealed decreased heat emission in the right forearm. It has been speculated that injury to the peripheral nerve may cause changes in the spinal cord or cerebral synaptic mechanisms which lead to clinical syndrome of causalgia and dystonia. Conversion reaction and malingering also have been suggested as a plausible cause of syndrome of post-traumatic dystonia.