7] CRPS

Question 1

Define CRPS type 1

Answer 1

syndrome that develops after an initiating noxious event that may or maynot be associated with a period of immobilization

Question 2

Define CRPS type 2

Answer 2

Differs from CRPS type I by the presence of a known injury to a nerve ornerves

Question 3

80-85% of CRPS ?

Answer 3

Have experiences preceding trauma from fractures or surgery

Question 4

Physiological changes with CRPS

Answer 4

Distal edema 
Skin temp - warm at first 
Initially red skin color and then pale in chronic disease 
More sweating 
More nail and hair growth

Question 5

Sensory changes in CRPS

Answer 5

Spontaneous pain
Hyperpathia
Hyperlagesia
Allodynia

Question 6

Motor changes with CRPS

Answer 6

Weakness
Distal tremors
Dystonia
Myoclonus

Question 7

Bony changes

Answer 7

Osteoporosis

Joint stiffness

Question 8

4 main hypothesis of CRPS

Answer 8

1] Facilitated neurogenic inflammation
2] Autonomic (sympathetic) dysfunction
3] Neuroplastic changes within the CNS
4] Autoimmunity

Question 9

Classic inflammatory signs are present in CRPS: pain, swelling, erythema,
hyperthermia and impaired function
• However, when clinical chemistry parameters for inflammation are evaluated, there are no differences between CRPS patients and controls

Answer 9

Neurogenic inflammation

Question 10

Pathological sympatho-afferent coupling: Peripheral
nociceptors develop adrenergic sensitivity (mainly alpha-2 receptors) such that tonic sympathetic efferent activity leads to their activation

Answer 10

Autonomic dysfunction

Question 11

Studies using functional brain imaging in patients
with CRPS have found a significant degree of cortical reorganization in the central sensory and motor
cortices

Answer 11

Neuroplastic changes within CNS

Question 12

Autoantibody-mediated autoimmune aetiology

• Serum from patients with CRPS compared to healthycontrols

Answer 12

Autoimmunity

Question 13

4 categories of Budapest criteria

Answer 13

Sensory
Vasomotor
Sudomotor/edema
Motor/tropic

Question 14

Define Budapest criteria

Answer 14

Have to have atleast one Sx in 3 out of 4 categories and display 1 sign at time of eval in 2 or more categories

Question 15

• Dysfunction of proprioceptive afferent feedback from theaffected tissue to subcortical and cortical regions
involved in perception of the body and regulation of
somatomotor and visceromotor reactions

Answer 15

Body perception disturbances

Question 16

Inaccurate portrait of actual location of body parts,

potentially resulting in disrupted sensorimotor function, which can lead to pain generation

Answer 16

Conflict of sensory and motor info

Question 17

3 types of therapy treatment for CRPS

Answer 17

Movement therapy
GMI (graded motor imagery)
Mirror box

Question 18

• Mobilization of the affected body part, begun

immediately following diagnosis of CRPS, is crucial to help prevent contractures

Answer 18

Movement therapy

Question 19

Exercises the brain in measured and monitored steps
• Left and right discrimination training
• Motor imagery exercises
• Mirror box therapy

Answer 19

Graded motor imagery

Question 20

Requires an individual to exercise their 
unaffected limb in 
front of a mirror, while watching the 
reflection, as if their 
affected limb were 
performing the 
exercise.

Answer 20

Mirror box therapy