Neglect-like symptoms in complex regional pain syndrome: Learned nonuse by another name?

The use of the term ‘neglect-like’ to characterise symptoms displayed by patients with complex regional pain syndrome (CRPS) has proved to be provocative. It has provided the stimulus for an ever-increasing number of studies exploring spatial perception in affected patients, with calls for further related studies . Although this work would undoubtedly be of interest, there are perhaps 2 important factors to consider if such studies are undertaken. Firstly, studies that have relied on standard clinical tests typically used to identify spatial neglect after stroke have not confirmed the presence of a related deficit in CRPS . Some deviations from normal have emerged using laboratory-based measures , but it is important to acknowledge that the extent of any deficit in spatial perception after CRPS is not comparable with that seen commonly after stroke. Second, it is worth remembering that the clinical observations that first gave rise to the term ‘neglect-like’ with regard to CRPS were dominated by observations relating to movement rather than to perceptual difficulties . It is noteworthy that since these initial observations were made, there has been relatively little attention paid in experimental studies to these interesting motor aspects of behaviour. In contrast to the recent review in Pain , here we consider the primary observation of ‘motor underuse’ in CRPS, looking at comparisons with ‘motor neglect’ and more generally with movement difficulties in pat...
Source: Pain - Category: Anesthesiology Authors: Tags: Topical review Source Type: research