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a Department of Neurology, Justus-Liebig-University, Giessen, Germany b Department of Anesthesiology, Justus-Liebig-University, Giessen, Germany c Department of Neurology, Gutenberg-University, Mainz, Germany
Key Words: complex regional pain syndrome • autoantibodies • autonomic nervous system
Address for correspondence: Dr. F. Blaes, Department of Neurology, Justus-Liebig-Universität, Am Steg 14, 35385 Giessen, Germany. Voice: +49-641-9945357; fax: +49-641-9945449. franz.blaes{at}neuro.med.uni-giessen.de
Complex regional pain syndrome (CRPS) is an etiologically unclear syndrome with the main symptoms being pain, trophic and autonomic disturbances, and functional impairment that develops after limb trauma or operation and is located at the distal site of the affected limb. Because autoantibodies against nervous system structures have been described in these patients, an autoimmune etiology of CRPS is discussed. These autoantibodies bind to the surface of peripheral autonomic neurons. Using a competitive binding assay, it can be shown that at least some of the CRPS sera bind to the same neuronal epitope. Autoimmune etiology of CRPS is a new pathophysiological concept and may have severe impact on the treatment of this often chronic disease.
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