Does Chemotherapy-Induced Peripheral Neuropathy Fall Within the Spectrum of Complex Regional Pain Syndrome? A Narrative Review.

Abstract

Purpose of review: Peripheral neuropathies and complex regional pain syndrome (CRPS) result in a similar clinical picture including shared sudomotor and vasomotor symptomatology. Chemotherapeutic agents can precipitate chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients akin to development of CRPS following trauma. Below we review the areas of overlap between CRPS and CIPN including their shared pathophysiology, clinical presentation, diagnostics, and treatment options.

Recent findings: The features of autonomic dysfunction, motor impairment, and reduced proprioception observed in both CRPS and CIPN may result from shared mechanisms include inflammatory reactions, immune dysregulation, autonomic changes, as well as central and peripheral sensitization. Both conditions are a clinical diagnosis of exclusion, and demand a personalized, multidisciplinary therapeutic approach inclusive of psychosocial interventions to reduce deleterious effects on an individual's quality of life. CIPN is recognized as a separate clinical entity albeit sharing a similar underlying pathology and clinical presentation with CRPS. It may be plausible to include CIPN on the CRPS clinical spectrum as our mechanistic understanding of its development and progression evolves.