Neurological Associates
Pain Management Center
Vero Beach, Florida
|
H. Hooshmand, M. D. |
|
DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY BOARD CERTIFIED IN ELECTROMYOGRAPHY BOARD CERTIFIED IN AMERICAN BOARD OF ELECTODIAGNOSTIC MEDICINE INTRACTABLE NEUROLOGY EPILEPSY, PAIN, MS An International Referral Center dedicated to Treatment, Education and Research |
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RSD PUZZLE #81
Diagnosis Of RSD With Nerve Blocks
There have been emphatic statements saying that RSD can only be diagnosed by sympathetic
nerve blocks. This may be true in approximately 90% of RSD patients in the first six
months, 60% of RSD patients in the first one year or around 50% of RSD patients in the
first two years. However, as the disease progresses, the sympathetic nerve block test
shows Sympathetically Independent Pain (SIP) in a high percentage of the patients. As a
matter of fact, after five years more than 4 out of 5 of the patients are SIP and the
nerve block is negative. There have been many patients that have been told that they do
not have RSD just because the sympathetic nerve block is negative, even though the patient
had been diagnosed with RSD for five to seven years.
RSD is not a simple hyperactivity of the sympathetic system. It is a dysfunctional and
rogue sympathetic system. The more chronic it becomes, the less likely it is to be
sympathetically mediated pain. RSD is not a diagnosis by exclusion or by nerve blocks. It
is a diagnosis made clinically and inclusively. The whole principles of:
1. Hyperpathic allodynic pain.
2. Muscle spasm with constriction and movement disorder.
3. Inflammation.
4. Disturbance of the limbic system causing insomnia, agitation and depression.
The above are the four minimum requirements and the most effective diagnostic criteria for
the accurate diagnosis of RSD. Bone Scan or Thermography are not accurate enough to
exclusively diagnose RSD.
H. Hooshmand, M.D.
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Copyright © 1997-2006 H. Hooshmand, M.D. No part of this publication may be reproduced, transmitted, stored in a retrieval system other than this specific media, transcribed, or translated into any language without the expressed written permission from the author; H. Hooshmand, M.D. and Eric Phillips and CMNE. This material is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician.
Send e-mail to Eric Phillips: EricmP9512@aol.com with questions or comments about this media and content.
The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.
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This page was last updated on 3/11/2000.
