Causalgia (complex regional pain syndrome type 2)

What is Causalgia?

Causalgia is a chronic pain condition seen after the section (damage, cutting) of a nerve. It is characterised by a chronic burning pain and hypersensitivity in the area supplied by that nerve.The sympathetic nerve supply of the involved area is believed to be important in the cause of Causalgia. The sympathetic nervous system is a network of nerves (separate from the set of nerves controllinng voluntary activities) which controls a lot of bodily functions (like our heart rate, intestinal activity) as well as being important in pain perception and skin blood supply.

Statistics on Causalgia?

This condition is most common in people between the ages of 40-60, but has been seen in younger people also.

Risk Factors for Causalgia

This condition most commonly follows trauma.

It is seen occasionally following amputation.

Progression of Causalgia

In the majority of people onset of the pain is within 24 hours of injury.

How is Causalgia Diagnosed?

It is possible to make a diagnosis based on a medical history and physical examination.

Prognosis of Causalgia

The ealier the dagnosis, the better the outcome. If the condition is recognized within the first stages, sometimes the condition will simply dissipate and normal movement will be possible with minimal changes.

How is Causalgia Treated?

Medical therapy is usually ineffective. Sympathetic block: 18-25% of patients have satisfactory long-lasting relief after a series of nerve blocks using a local anesthetic injection. Surgical sympathectomy: This involves cutting the sympathetic nerves to that area of the body, and it relieves pain in more than 90% of patients. Sympathectomy has been reported to provide complete relief in over 80% and significant relief in 95% of patients with causalgia.The risk of significant complication is approximately 5%. These include a pneumothorax (punctured lung), intercostal nerve pain, spinal cord injury, and Horner's syndrome (droopy eyelid due to nerve damage).

Causalgia References

[1] G.D. Schott, Interrupting the sympathetic outflow in causalgia and reflex sympathetic dystrophy.(Editorial); British Medical Journal, March 14, 1998;[2] Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002 Pg 1150[3] UCLA Neurosurgery