@entity1118 in a distal extremity that is accompanied by @entity5433 in the same region is taken to indicate @entity6865 . Typically, @entity1931 to light touch is present in addition to the spontaneous @entity158 . The absence of @entity1931 indicates that the underlying mechanism is central rather than peripheral sensitization. This mechanism is similar to that of secondary @entity1931 in the intact skin surrounding an injury site. Sympathetically maintained @entity158 (SMP) is diagnosed, when these sensory symptoms are reversible under sympathetic blockade. SMP is not due to @entity2915 of sympathetic efferents but to receptor supersensitivity, probably by overexpression of alpha(1)-adrenergic receptors on nociceptive primary afferents. This way normal levels of @entity1063 can cause pathological spontaneous activity of nociceptors which maintains the central sensitization. @entity1118 and @entity1931 may also be independent of the sympathetic innervation of the skin. In this case, central sensitization is maintained by other mechanisms. A role of the sympathetic nervous system in the pathogenesis of @entity158 cannot be deduced simply from the simultaneous presence of sensory and autonomic clinical signs and symptoms. Therefore, sympathetic blockade in a @entity1 initially is a diagnostic procedure, aiming to demonstrate the presence of the symptom SMP. Therapeutic blockade is only indicated after this demonstration. For the substantial number of @entity1 with sympathetically independent @entity158 , other treatment modalities are needed which may for @entity6220 .

[Pathophysiology and diagnosis in @entity1 with sympathetically dependent XXXX ].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity6220 :: ('MESH:D020279', 'Disease') :: ['example attack central sensitization'] @entity1931 :: ('MESH:D006930', 'Disease') :: ['hyperalgesia', 'cutaneous hyperalgesia', 'heat hyperalgesia'] @entity6865 :: ('MESH:D012019', 'Disease') :: ['reflex sympathetic dystrophy'] @entity2915 :: ('MESH:D006948', 'Disease') :: ['hyperactivity'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity5433 :: ('MESH:C563939', 'Disease') :: ['autonomic dysfunction'] @entity1063 :: ('MESH:D009638', 'Chemical') :: ['norepinephrine'] @entity1118 :: ('MESH:D059350', 'Disease') :: ['Chronic burning pain', 'Chronic pain']
@entity158 :: (MESH:D010146,Disease) :: ['pain']
