Orofacial complex regional pain syndrome.

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Abstract

[Indexed for MEDLINE] 11. Clin Neurol Neurosurg. 2025 Oct;257:109035. doi: 10.1016/j.clineuro.2025.109035. Epub 2025 Jun 30. Risk factors analysis of post-stroke complex regional pain syndrome in patients with first-ever subacute stroke. Kim CY(1), Kim YB(2), Lee ES(3). Author information: (1)Department of Physical Medicine of Rehabilitation, Wonkwang University School of Medicine Hospital, Institut of Wonkwang Medical Science, Republic of Korea. Electronic address: cy7974@naver.com. (2)Department of Physical Medicine of Rehabilitation, Wonkwang University School of Medicine Hospital, Institut of Wonkwang Medical Science, Republic of Korea. Electronic address: ybk1077@naver.com. (3)Department of Physical Medicine of Rehabilitation, Wonkwang University School of Medicine Hospital, Institut of Wonkwang Medical Science, Republic of Korea. Electronic address: dmstjs0802@naver.com. BACKGROUND: Post-stroke complex regional pain syndrome (CRPS) is an important complication in stroke survivors; however, the risk factors associated with CRPS are not well understood. METHODS: Demographic data, duration of hospitalization, location of brain lesion, etiology, comorbidities, and findings of certain blood tests related to the patient's nutritional status (vitamin D, plasma protein, and albumin levels) and thrombotic disease (serum fibrinogen/fibrin degradation products and D-dimer levels) were investigated. Clinical data included scores of Fugl-Meyer assessment for the upper extremity (FMA-UE), National Institute for Health stroke scale (NIHSS). CRPS was clinically diagnosed according to the Budapest criteria and confirmed by a Three-Phase Bone Scan RESULTS: Among the 226 patients with subacute stroke, 45 were diagnosed with CRPS and 181 were in placed in the control group. In the CRPS group, supratentorial lesions and a history of coronary artery disease were predominant, and plasma albumin levels were low. Independent risk factors for CRPS included long duration of hospitalization, low score of FMA-UE, high initial NIHSS and low plasma protein level. Etiology of stroke, the dominance or non-dominance of the affected hemisphere, unilateral or bilateral brain lesions, history of hypertension, diabetes mellitus, dyslipidemia, deep vein thrombosis, pulmonary embolism and depression were not involved in the occurrence of CRPS. CONCLUSIONS: Risk factors of post-stroke CRPS in patients with first-ever subacute stroke included long duration of hospitalization, low strength of the affected upper limb, high initial NIHSS score, and protein-energy malnutrition. Copyright © 2025. Published by Elsevier B.V. DOI: 10.1016/j.clineuro.2025.109035