• Clin J Pain · Dec 1989

    Review

    Norepinephrine in reflex sympathetic dystrophy: an hypothesis.

    • A Ecker.
    • Department of Neurosurgery, State University of New York Health Science Center, Syracuse.
    • Clin J Pain. 1989 Dec 1; 5 (4): 313-5.

    AbstractReflex sympathetic dystrophy (RSD) usually occurs in an individual who has been experiencing significant personal stress, a state associated with increased discharge of norepinephrine (NE) from perivascular postganglionic sympathetic neurons. RSD is often precipitated by this sequence: traumatic arterial spasm, regional ischemia, neurogenic inflammation, and ischemic/edematous damage to membranes of preterminal perivascular nociceptive neurons. In the natural repair of these membranes, it is suggested that adrenoceptors appear and are ordinarily transitory; but in RSD, they are retained by the increased adjacent NE. This process delays further healing, produces pain, and releases inflammatory substances, resulting in interacting pathophysiologic vicious cycles.

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