Erythromelalgia

ERYTHROMELALGIA (erythromelalgia), or Weir-Mitchell disease, is a rarely occurring disease belonging to the group of vasomotor neuroses with unclear etiology and pathogenesis. E. is characterized by the appearance of sharp, burning, sometimes unbearable pain in the distal parts of the extremities (acromelalgia), with intense reddening (arterial hyperemia), swelling, and increased temperature. The feet are most commonly affected, less often the hands, sometimes all four extremities. Cases of hemiplegic type involvement are known. The E. syndrome often arises spontaneously without connection to any other diseases of the nervous system—the idiopathic form (Cassirer, Curschmann). But alongside the idiopathic form, there exists the so-called symptomatic E., developing in the presence of other diseases of the nervous system, both from the group of angiotrophoneuroses (scleroderma, acroparesthesia) and in diseases accompanied by significant destruction of the central nervous system, such as apoplexy, multiple sclerosis, etc. The E. syndrome is also observed in arsenic poisoning. Attacks of E. may begin spontaneously, but more often occur in connection with overheating or overexertion, or particularly frequently when the extremities are dependent. At the height of an attack, sensitivity of the affected area is not disturbed. Sometimes there is hyperesthesia. There is indication of greater morbidity in men. E. poorly responds to treatment, which consists mainly in the application of various physical therapy procedures. One of the synonyms for E. is oedema cutis circumscripta dolorosa.