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Mark E. Foglesong
Neurological Sciences Institute of Good Samaritan Hospital and Medical Center 1120 NW 20th Ave Portland, OR 97209

Arch Neurol. 1988;45(3):243-244.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Two aspects of the recent review of reflex sympathetic dystrophy (RSD) presented by Schwartzman and McLellan invite comment.¹

First, the statement that RSD is "a syndrome of burning pain, hyperesthesia, swelling, hyperhidrosis, and trophic changes in the skin and bone of the affected extremity" obscures the fact that not all of these signs and symptoms are present in all cases of RSD. The essential features of RSD are as follows: (1) a spontaneous burning pain accompanied by (2) a painful sensation to gentle touch in the affected area (allodynia or hyperpathia); and (3) relief of these pains by sympathetic block.² Secondary signs such as dystrophic tissue and bone loss do not occur until later stages of the disease, and probably result from chronic disuse and extreme guarding behavior.^3,4 Sympathetic hyperfunction is also not a prerequisite for the diagnosis of RSD, as many patients with RSD have normal . . . [Full Text PDF of this Article]

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