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Explaining reflex sympathetic dystrophy 

Explaining reflex sympathetic dystrophy
Chapter:
Explaining reflex sympathetic dystrophy
Author(s):

Brigitta Brandner

DOI:
10.1093/med/9780198834359.003.0003
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date: 19 February 2020

The medical community had long been aware of a constellation of symptoms involving pain, bone atrophy, and trophic changes that could occur following a trauma; however, this paper was the first to unify and explain the syndrome. James Evans amalgamated other theories of the time and was the first to realize the fundamental role of the autonomic nervous system in explaining the pathophysiology of the condition, which he named ‘reflex sympathetic dystrophy’. Evans uses 57 cases histories to highlight the variety of noxious stimuli that may result in reflex sympathetic dystrophy, and goes onto outline the local anaesthetic blocks and sympathectomies he used to treat them. This is a seminal paper because Evans is the first to use the term ‘reflex sympathetic dystrophy’ and, in doing so, proposes an underlying mechanism for a disease process that, while known, was until then very poorly understood.

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