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Review
. 2020 Jan-Mar;19(1):68-70.
doi: 10.4103/aam.aam_23_19.

Complex regional pain syndrome: A case report and review of the literature

Nura H Alkali  1 , Abdulrahman M Al-Tahan  2 , Mohammad Al-Majed  3 , Husam Al-Tahan  4
Affiliations
Review

Complex regional pain syndrome: A case report and review of the literature

Nura H Alkali et al. Ann Afr Med. 2020 Jan-Mar.

Abstract
in English, French

Background: Complex regional pain syndrome (CRPS) is a rare neuropathic pain disorder associated with severe pain, muscle weakness, limb edema and hyperhidrosis. Predisposing factors include fracture, surgery, stroke and spinal cord injury. CRPS may recur in the same limb or spread to other limbs to complicate management.

Case report: A 20-year old female with CRPS Type-I had sequential spread to all four limbs despite different treatment modalities, including medical therapy, nerve block, radiofrequency ablation and surgical sympathectomy. We discuss the therapeutic challenges and reviewed recent literature on current treatment options for CRPS Type-I.

Conclusion: A multidisciplinary approach is needed for effective management of CRPS, and refractory disease may respond to intrathecal baclofen with morphine.

RésuméContexte: Le syndrome douloureux régional complexe (SDRC) est un trouble neuropathique rare associé à une douleur intense, une faiblesse musculaire, un dème des membres et une hyperhidrose. Les facteurs prédisposants comprennent la fracture, la chirurgie, l'AVC et les lésions de la moelle épinière. Le SDRC peut se reproduire dans le même membre ou se propager à d'autres membres pour compliquer la gestion. Rapport de cas: une femme de 20 ans atteinte du SDRC de type I s'est propagée séquentiellement aux quatre membres malgré différentes modalités de traitement, y compris une thérapie médicale, un bloc nerveux, une ablation par radiofréquence et une sympathectomie chirurgicale. Nous discutons des défis thérapeutiques et avons passé en revue la littérature récente sur les options de traitement actuelles pour le SDRC de type I. Conclusion: Une approche multidisciplinaire est nécessaire pour une gestion efficace du SDRC, et la maladie réfractaire peut répondre au baclofène intrathécal avec de la morphine.

Keywords: Complex regional pain syndrome; sympathectomy; sympathetic block.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Pictures showing the patient with left lower limb edema (a) which persisted with radiofrequency ablation of lumbar sympathetic nerves but resolved after lumbar sympathectomy with phenol injections (b). Symptoms later recurred in the right hand (c) but responded to intrathecal baclofen infusion (d)
See this image and copyright information in PMC

References

    1. Dutton K, Littlejohn G. Terminology, criteria, and definitions in complex regional pain syndrome: Challenges and solutions. J Pain Res. 2015;8:871–7. - PMC - PubMed
    1. Harden RN, Bruehl S, Perez RS, Birklein F, Marinus J, Maihofner C, et al. Validation of proposed diagnostic criteria (the “Budapest criteria”) for complex regional pain syndrome. Pain. 2010;150:268–74. - PMC - PubMed
    1. Birklein F, Schlereth T. Complex regional pain syndrome-significant progress in understanding. Pain. 2015;156(1):S94–103. - PubMed
    1. van Rijn MA, Marinus J, Putter H, Bosselaar SR, Moseley GL, van Hilten JJ. Spreading of complex regional pain syndrome: Not a random process. J Neural Transm (Vienna) 2011;118:1301–9. - PMC - PubMed
    1. Goh EL, Chidambaram S, Ma D. Complex regional pain syndrome: A recent update. Burns Trauma. 2017;5:2. - PMC - PubMed

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