Reflex sympathetic dystrophy

35 patients with syndrome of reflex sympathetic dystrophy (RSD) were examined clinically by means of psychological tests, method of evoked skin sympathetic potentials (ESSP) and nociceptic flexor reflex R III. RSD syndrome had central origin (after strokes) in 17 patients (group I) while in 18 patients it arose after some peripheral damages (group II). RSD syndrome was characterised in both groups by triad of symptoms: acute pain, autonomic disorders and osteoporosis. Decreased life quality high anxiety and depression were quite characteristic for the patients with RSD. Both significant prolongation of latent period and decrease of amplitudes of ESSP were observed on the damaged limb in both groups of patients. These damages were evidently connected with disorders of central-peripheral autonomic interactions in paretic limbs in group I, in group II they were conditioned by damages in peripheral sympathetic sudomotor fibers. Significant increase of both thresholds of pain perception and flexor reflex was found in patients with RSD while the value of the coefficient of their correlation was decreased. Such disorder might be caused by initial insufficiency of antinociceptive functions and that permitted to suggest the hypothesis about the role of this factor in pathogenesis of RSD syndrome and in development of chronic pain its leading symptom. The conclusion was drawn that development of RSD syndrome was not associated with location, severity and character of the damage, but It was conditioned mainly by the state of functions of cerebral antinociceptive systems as well as by emotional and personal peculiarities of the patients.