A mysterious case of complex regional pain syndrome in a 9-year-old girl

Disabil Rehabil. 2019 Apr;41(8):991-993. doi: 10.1080/09638288.2017.1413430. Epub 2017 Dec 7.

Abstract

Purpose: To describe the clinical manifestation and the treatment of complex regional pain syndrome type II in childhood.

Methods: Using information on the symptoms, diagnosis, rehabilitation and outcome of a young patient with complex regional pain syndrome type II.

Results: A 9-year -old girl had severe pain in the region of the left foot, signs of a common fibular nerve entrapment, hyperalgesia not limited to the distribution of the injured nerve, weakness and temperature asymmetry unknown origin. She consulted few doctor's before she was given the right diagnosis of complex regional pain syndrome type II. Following the diagnosis the treatment started, it included intensive physiotherapy, electrical therapy and also supportive psychological therapy. Half a year later, the patient was free of the daily pain and returned to all physical activity without any restrictions.

Conclusions: The case report illustrates that peripheral nerve compression or injuries specifically, complex regional pain syndrome type II, should be taken into consideration when evaluating children with weakness and pain of the lower or upper limb. Implication of rehabilitation Raising the awareness of complex regional pain syndrome in the childhood is essential for an early diagnosis and appropriate treatment. The treatment options include early and adequate pain management inclusive electrical therapy and physiotherapy. Psychological therapy helps to avoid psychological stress reaction and the disease negative impact on the child's education and sports and the family social life.

Keywords: CRPS; childhood; physical therapy; thermography.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Complex Regional Pain Syndromes* / diagnosis
  • Complex Regional Pain Syndromes* / physiopathology
  • Complex Regional Pain Syndromes* / psychology
  • Complex Regional Pain Syndromes* / rehabilitation
  • Electric Stimulation Therapy / methods*
  • Exercise
  • Female
  • Foot* / innervation
  • Foot* / physiopathology
  • Humans
  • Hyperalgesia / diagnosis
  • Hyperalgesia / etiology
  • Hyperalgesia / therapy
  • Nerve Compression Syndromes / diagnosis
  • Nerve Compression Syndromes / physiopathology
  • Nerve Compression Syndromes / therapy
  • Pain Measurement / methods
  • Physical Therapy Modalities*
  • Psychological Techniques*
  • Treatment Outcome