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REFLEX SYMPATHETIC DYSTROPHY

SELMONOSKY DEFINITION

Reflex Sympathetic Dystrophy is thought to be present when a patient who has a diagnosed or undiagnosed entrapment neuropathy suffer an injury not affecting directly the nerves. The injury can be severe or very mild and the patients develop symptoms of pain and sympathetic hyperactivity of the hands.

The sympathetic hyperactivity is caused by a somato-sympathetic reflex that is produced by compression of the sympathetic fibers in the medial cord of the brachial plexus. These patients are generally very depressed and react to the injury with excessive pain and immobility of the extremity.

Therefore Reflex Sympathetic Dystrophy does not mean an etiological diagnosis, but the beginning of a differential diagnosis. Entrapment neuropathies, extent of the sympathetic hyperactivity and reversibility and the degree of depression.

In the upper extremities the most common etiological factor is Thoracic Outlet Syndrome.