Lecture given to the North British Pain Association on 16th May 2008 by Dr Candy McCabe. In this talk, Dr McCabe discusses the mechanisms and assessment of patients with complex regional pain syndrome.

1. Assessment of Complex Regional Pain Syndrome Dr. Candy McCabe Consultant Nurse arc Senior Lecturer in Rheumatology Nursing Royal National Hospital for Rheumatic Diseases & School for Health, University of Bath, Bath The North British Pain Association 2008

2. Rene Descartes 1596-1650 “ I think therefore I am” Jean-Jacques Rousseau, 1712-1778 “ I FEEL therefore I am”

3. Silas Weir Mitchell 1829-1914 Turner’s Lane Hospital, Philadelphia

9. McCabe et al. Rheumatology 2003 Referred Sensations in CRPS

10. Halligan PW et al. BMJ 1999 Referred Sensations in Amputees

12. Wilder Penfield

17. Sensory events are analysed in terms of appropriate motor response. Von Holst & Mittelstaedt; 1950. Wolpert et al.; 1995, Frith et al.; 2000 Baseline information

18. Motor simulation network and motor planning Von Holst & Mittelstaedt; 1950. Wolpert et al.; 1995, Frith et al.; 2000 Baseline information MSN

20. CRPS and sensory-motor conflict Baseline information MSN Corrupted Imagined or actual movements will cause a range of sensory/motor disturbances

21. Access to the basic building blocks Snyder AW, Mitchell DJ. Proc.R.Soc. Lond. 1999;2666:587-592.

22. Link to current clinical signs? Foreshortened limbs/ Altered body perception? Autotomy/ desire for amputation?

23. Link to current clinical signs? Increased peri-personal space Farné A, Làdavas E. Neuropreport 2000; 85:1645-1649.

24. Correcting motor sensory mismatch – 3 potential target areas Von Holst & Mittelstaedt; 1950. Wolpert et al.; 1995, Frith et al.; 2000 Baseline information MSN