[儿童和青少年复杂区域疼痛综合征和功能性神经紊乱:多样性中的统一]。

Harefuah Pub Date : 2024-09-01
Jana Landa, Tamar Silberg, Maya Gerner, Etzyona Eisenstein, Sharon Barak
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引用次数: 0

摘要

简介功能性神经紊乱(FND)和复杂性区域疼痛综合征(CRPS)是影响生活质量的疾病。CRPS 的诊断基于布达佩斯标准,其中包括各种体征/症状。尽管 FND 和 CRPS 的病因/病理生理学相似,但这两种疾病在青少年中的共同发病率尚未见报道。鉴于这两种现象在儿科患者中并不常见,因此彻底了解它们的特征并建立明确的鉴别诊断至关重要。这反过来对指导治疗干预具有重要意义:我们旨在研究1) FND 患儿的临床特征;2) CRPS 在 FND 患儿中的患病率;3) FND 患儿与合并诊断 FND 和 CRPS 的患儿在临床特征和布达佩斯症状/体征方面的差异:研究对象为 61 名确诊为 FND 的儿童(平均年龄:13.70+2.93 岁;75.4% 为女性)。从医疗档案中收集了样本的人口统计学特征、临床特征和布达佩斯 CRPS 分类标准:大多数 FND 患儿都有感觉症状(67%)和运动症状(88%)。44%的患儿被同时诊断为FND和CRPS。在这些患儿中,100%报告了感觉和运动/典型症状,74%报告了血管运动症状,65%报告了淋巴运动症状。与单纯患有FND的儿童相比,合并诊断的儿童中除运动功能障碍外,布达佩斯症状的发生率明显更高:结论:CRPS和FND并发症患儿的症状和临床体征发生率较高,这可能表明两者有共同的发育机制,对制定适当的康复干预措施非常重要。
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[COMPLEX REGIONAL PAIN SYNDROME AND FUNCTIONAL NEUROLOGICAL DISORDER IN CHILDREN AND ADOLESCENTS: UNITY IN DIVERSITY].

Introduction: Functional neurological disorder (FND) and complex regional pain syndrome (CRPS) are disorders that affect quality of life. CRPS diagnosis is based on Budapest criteria that include various signs/symptoms. Despite the similarity in the etiology/pathophysiology of FND and CRPS, the joint prevalence of these two conditions in youth has not yet been reported. Given that both phenomena are less familiar among pediatric patients, it is crucial to thoroughly characterize them and establish a clear differential diagnosis. This, in turn, holds significant implications for guiding therapeutic interventions.

Objectives: We aimed to examine: 1) the clinical profile of children with FND; 2) the prevalence of CRPS among children with FND; and 3) differences in clinical characteristics and in Budapest's symptoms/signs between children with FND and those with a co-diagnosis of FND and CRPS.

Methods: Sixty-one children (mean age: 13.70+2.93 years; 75.4% females) diagnosed with FND were studied. Sample's demographic, clinical characteristics and the Budapest CRPS classification criteria were collected from medical files.

Results: Most children with FND reported sensory (67%) and motor (88%) symptoms. Forty-four percent had a co-diagnosis of FND and CRPS. Among these children, 100% reported sensory and motor/tropical, 74% vasomotor, and 65% sudomotor symptoms. The prevalence of Budapest symptoms, except for motor-function impairment, was significantly higher among children with a co-diagnosis compared to children with FND alone.

Conclusions: The high frequency of symptoms and clinical signs in children with co-incidence of CRPS and FND may indicate a shared developmental mechanism and is important for the development of appropriate rehabilitation interventions.

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