• C S McCabe, R C Haigh, P W Halligan, and D R Blake.
• The Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath BA1 1RL, UK. candy.mccabe@rnhrd-tr.swest.nhs.uk
• Rheumatology (Oxford). 2003 Sep 1; 42 (9): 1067-73.

ObjectivesThis study sought to explore and characterize referred sensations (RS) in patients with complex regional pain syndrome (CRPS) type 1 and test the hypothesis that pain in CRPS is associated with central sensory changes.MethodsSubjects underwent standardized neurological examination involving light touch, pinprick and vibration sense with eyes closed and then with eyes open. The subjects described the location and sensation emanating from the stimulated site and whether they experienced any sensations (similar or different) elsewhere.ResultsFive of 16 subjects recruited demonstrated RS. These were experienced in real time, were modality specific (touch and pinprick) and were located on the body part immediately adjacent, on Penfield's cortical homunculus, to the stimulated site. The RS were diminished or absent when the subject visualized the stimulated area. They disappeared when stimulation ceased and on clinical improvement.ConclusionsThis is the first report of RS in CRPS and provides further evidence of central reorganization in what was previously thought to be a peripheral disorder.

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