Small fiber degeneration in post-stroke complex regional pain syndrome I.

摘要

A 37-year-old man had a massive right middle cerebral artery infarct causing left hemiparesis. He developed chronic poststroke complex regional pain syndrome type I (CRPS I) of the left foot and distal leg (DL) with pain, allodynia, edema, skin hyperemia, and hair loss. Vascular studies and an EMG were normal. Skin biopsy with PGP9.5 immunostaining showed complete loss of intraepidermal somatic C-fibers at the left foot (figure, B) and reduced density at the DL {figure, F).