Functional and Dissociative Neurological Symptoms : a patient's guide

Hemi

Complex Regional Pain

Budapest clinical diagnostic criteria for Complex Regional Pain Syndrome:

Diagnostic criteria (1–4 must be satisfied):

1. Continuing pain, which is disproportionate to any inciting event

2. Must report at least one symptom in three of the four following categories:
Sensory: reports of hyperesthesia and/or allodynia
Vasomotor: reports of temperature asymmetry and/or skin color changes and/or skin color asymmetry
Sudomotor/edema: reports of edema and/or sweating changes and/or sweating asymmetry
Motor/trophic: reports of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
3. Must display at least one sign at time of evaluation in two or more of the following categories:
Sensory: evidence of hyperalgesia (to pinprick) and/or allodynia (to light touch and/or deep somatic pressure and/or joint movement)
Vasomotor: evidence of temperature asymmetry and/or skin color changes and/or asymmetry
Sudomotor/edema: evidence of edema and/or sweating changes and/or sweating asymmetry
Motor/trophic: evidence of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
There is no other diagnosis that better explains the signs and symptoms

Terms:
Oedema - Swelling
Sudomotor Activity - Usually refers to colour change or change in blood flow
Allodynia - Describes a painful response to a non-painful stimulus. for example, brushing the skin lightly against bedclothes is painful
Hyperalgesia - Increased sensitivity to stimuli that are normally painful