J Korean Pain Soc.  1990 Dec;3(2):165-171.

Effects of Repeated Sympathetic Blocks for Reflex Sympathetic Dystrophy Syndromes: A Case Report

• Bae WH
• Roh SJ
• Goh JS
• Min BW

Abstract

The reflex sympathetic dystrophy syndrome (RSDS) consists of sustained burning pain and tenderness, vasomotor instabilitiy, swelling, occasional functional instability, trophic skin change and edema of extremity following trauma, peripheral nerve injury, spinal cord injury, infection, burn and other etiologic factors. The most important thing in RSDS is to start the treatment as soon as the disease was diagnosed. Most patients with RSDS respond dramatically and permanently to sympathetic blocks if treatment is instituted before irreversible trophic changes. The characteristic radiological finding in RSDS is a patchy osteoporosis in the cancellous bone. Periarticular hyperactivity is seen in RSDS by Tc99m bone scan. We have managed 4 cases of RSDS. The methods of management and effects are as follows: 1) In case 1, 28 lumbar sympathetic blocks in both sides were performed. The patient did not complain of pain or tenderness and the limping improved. 2) In case 2, 7 lumbar sympathetic blocks were performed, but we could find only a slight improvement in the symptoms. 3) In case 3, 8 stellate ganglion blocks were carried out. The patient refused the treatment of RSDS because of the lack of rapid improvement. 4) In case 4, total 64 stellate ganglion blocks were carried out; the patient was permanently improved.

MeSH Terms

Burns
Edema
Extremities
Humans
Osteoporosis
Peripheral Nerve Injuries
Reflex Sympathetic Dystrophy*
Reflex*
Skin
Spinal Cord Injuries
Stellate Ganglion