Article

The objective was to determine whether the abnormal finding of
somatosensory evoked potentials (SEPs) associated with the development of type I
complex regional pain syndrome (CRPS) after stroke. METHODS: This was a
retrospective study conducted from January, 2003, to December, 2007. Seventy
patients were confirmed as CRPS type I, and one hundred and eighty-two patients
were assigned to the control group. The initial clinical data were reviewed
including age, gender, main type of stroke, lateralization and location of the
lesion, presence of glenohumeral subluxation, and the development of CRPS.
Somatosensory evoked potentials tests (SEP) in median nerve (N20) and posterior
tibial nerve (P37) were performed. RESULTS: CRPS groups revealed significantly
higher incidence of the absent and abnormal hemiplegic median SEP, hemorrhagic
stroke, and glenohumeral subluxation (GHS). Binary logistic regression analysis
indicated that GHS (exp.(B)=4.083, p<0.01) with the absent median SEP
(exp.(B)=3.246, p<0.01) were significant independent predictors of CRPS onset.
CONCLUSIONS: In conclusion, GHS and the absent median SEP at sub-acute phase of
stroke were primary predictors of the onset of post-stoke CRPS. Implications for
Rehabilitation Recent investigations have suggested that autonomic, motor and
somatosensory abnormalities of CRPS are impairments involving the central nervous
system (CNS) as well as the peripheral neurogenic inflammatory process. However,
the understanding of the pathophysiology of CRPS is still far from complete. The
absence of SEP at the sub-acute stage of stroke correlated with the onset of
post-stroke CRPS type I. The SEP evaluation at the sub-acute period after stroke
might be generally used for predicting the concomitant development of post-stroke
CRPS type I as well as functional recovery after stroke.

Langue : ANGLAIS