Synonyms
SMP; sympathetically maintained pain; CRPS; complex regional pain syndrome
Definition
Neuropathic pain patients can be divided into groups based on their response to selective sympathetic blockade or antagonism of α-adrenoreceptor mechanisms (Price et al. 1998). The component of spontaneous and evoked pain (hyperalgesia) which is relieved by specific sympatholytic procedures is termed sympathetically maintained pain (SMP). Hyperalgesia can be defined as a leftward shift of the stimulus response function that relates the magnitude of pain to the intensity of a noxious stimulus. An increased sensitivity to painful heat is termed thermal hyperalgesia. Hyperalgesia can also be evoked by application of different mechanical stimuli; for instance, punctate stimuli (e.g. firm von Frey hairs) can evoke punctate hyperalgesia, whereas gently stroking sensitized skin with a cotton swab can provoke dynamic hyperalgesia (also termed mechanical allodynia).
Intradermal injection or...
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References
Ali Z, Raja S, Wesselmann U et al. (2000) Intradermal Injection of Norepinephrine Evokes Pain in Patients with Sympathetically Maintained Pain. Pain 88:161–168
Chen Y, Michaelis M, Jänig W et al. (1996) Adrenoreceptor Subtype Mediating Sympathetic-Sensory Coupling in Injured Sensory Neurons. J Neurophysiol 76:3721–3730
Davis KD, Treede RD, Raja SN et al. (1991) Topical Application of Clonidine Relieves Hyperalgesia in Patients with Sympathetically Maintained Pain. Pain 47:309–317
Drummond PD, Skipworth S, Finch PM (1996) Alpha 1-adrenoreceptors in Normal and Hyperalgesic Human Skin. Clin Sci 91:73–77
Drummond PD (1998) Enhancement of Thermal Hyperalgesia by Alpha-Adrenoreceptors in Capsaicin-Treated Skin. J Auton Nerv Syst 69:96–102
Fuchs PN, Meyer RA, Raja SN (2001) Heat, but not Mechanical Hyperalgesia, following Adrenergic Injections in Normal Human Skin. Pain 90:15–23
Kingery WS (1997) A Critical Review of Controlled Clinical Trials for Peripheral Neuropathic Pain and Complex Regional Pain Syndromes. Pain 73:123–139
Price DD, Long S, Wilsey B et al. (1998) Analysis of Peak Magnitude and Duration of Analgesia Produced by Local Anesthetics into Sympathetic Ganglia of Complex Regional Pain Syndrome Patients. Clin J Pain 14:216–226
Verdugo RJ, Ochoa JL (1994) ‘Sympathetically Maintained Pain.’ I. Phentolamine Block Questions the Concept. Neurology 44:1003–1010
Wahren LK, Torebjörk E, Nystrom B (1991) Quantitative Sensory Testing Before and After Regional Guanethidine Block in Patients with Neuralgia in the Hand. Pain 46:23–30
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© 2007 Springer-Verlag Berlin Heidelberg
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Drummond, P., Schattschneider, J. (2007). Sympathetically Maintained Pain, Clinical Pharmacological Tests. In: Schmidt, R., Willis, W. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-29805-2_4338
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DOI: https://doi.org/10.1007/978-3-540-29805-2_4338
Publisher Name: Springer, Berlin, Heidelberg
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