Abnormalities of Cutaneous Blood Flow Regulation in Patients With Reflex Sympathetic Dystrophy as Measured by Laser Doppler Fluxmetry

doi:10.1001/archneur.1991.00530210038020

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Vol. 48 No. 9, September 1991

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Abnormalities of Cutaneous Blood Flow Regulation in Patients With Reflex Sympathetic Dystrophy as Measured by Laser Doppler Fluxmetry

Mark D. Bej, MD; Robert J. Schwartzman, MD

Arch Neurol. 1991;48(9):912-915.

Abstract

• The response of cutaneous blood flow to autonomic stimuliwas evaluated in eight patients with clinically staged reflexsympathetic dystrophy and eight healthy control subjects. Bloodflow was measured in the affected and contralateral extremitiesby laser Doppler fluxmetry. Five autonomic stimuli were appliedto the contralateral extremity during blood flow measurementin the ipsilateral affected extremity. Affected limbs of patientswith reflex sympathetic dystrophy were found to have statisticallysignificantly increased blood flow during the Valsalva maneuverand cold pressor test, while blood flow decreased in normalcontrols. No significant differences were found in limb temperatureor baseline blood flow between patients and controls. Reflexsympathetic dystrophy stage did not affect response to the procedures.Control subjects demonstrated a rhythmic cycling of cutaneousblood flow that was absent in patients with reflex sympatheticdystrophy. These results support a central abnormality of thesympathetic nervous system in reflex sympathetic dystrophy.

Author Affiliations

From the Department of Neurology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pa.

Footnotes

Accepted for publication January 2, 1991.

Reprint requests to the Department of Neurology, Jefferson MedicalCollege, 1025 Walnut St, Suite 511, Philadelphia, PA 19107 (DrSchwartzman).

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