A study of bone densitometry in patients with complex regional pain syndrome after stroke

Citation
V. Kumar et al., A study of bone densitometry in patients with complex regional pain syndrome after stroke, POSTG MED J, 77(910), 2001, pp. 519-522
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
POSTGRADUATE MEDICAL JOURNAL
ISSN journal
0032-5473 → ACNP
Volume
77
Issue
910
Year of publication
2001
Pages
519 - 522
Database
ISI
SICI code
0032-5473(200108)77:910<519:ASOBDI>2.0.ZU;2-5
Abstract
Introduction-This study was undertaken to evaluate the bone mineral density (BMD) in patients with complex regional pain syndrome type-I (CRPS-I) afte r stroke, and to correlate it with various clinical and neurophysiological parameters. Patients and methods-Twenty patients with CRPS-I after stroke were included and a detailed neurological evaluation was carried out. The severity of CR PS-I was graded on the basis of shoulder hand syndrome score. All the patie nts underwent bone mineral densitometry of paralysed and non-paralysed fore arm by dual energy x ray absorptiometry. The BMD of paralysed forearm was a lso compared with that of age matched healthy controls. Neurophysiological tests included sympathetic skin response in both upper and lower limbs and median somatosensory evoked potentials. Results-The mean age of patients was 57.2 (45-75) years and eight were fema les. Eight patients had severe weakness and 12 had moderate weakness of gra de 2 on the hemiplegic side. There was significant reduction in BMD in the patients compared with controls (p <0.01). The bone density reduction corre lated well with duration of illness (r = -0.673, p <0.01), shoulder hand sy ndrome score (r = -0.804, p <0.01), and Canadian neurological scale score ( r = -0.738 p <0.01). Sympathetic skin response was not recordable bilateral ly in all patients. Median somatosensory evoked potentials were not recorda ble in seven out of 20 patients who also had higher grade of CRPS-I. Conclusion-Our results show significant reduction of BMD in patients with C RPS-I after stroke. The reduction in BMD correlates with the severity of sh oulder hand syndrome score, degree of weakness, duration of hemiplegia, and the severity of stroke.