Korean J Pain.  2007 Jun;20(1):60-65. 10.3344/kjp.2007.20.1.60.

Cervical and Thoracic Spinal Cord Stimulation in a Patient with Pediatric Complex Regional Pain Syndrome: A case report

• Park JJ
• Moon DE
• Park SJ
• Choi JI
• Shim JC

• KMID: 2278042
• DOI: http://doi.org/10.3344/kjp.2007.20.1.60

Abstract

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist.

Keyword

complex regional pain syndrome; pediatric; spinal cord stimulation

MeSH Terms

Adolescent
Adult
Ankle
Causalgia
Child
Complex Regional Pain Syndromes
Diagnosis
Electrodes
Ganglia, Sympathetic
Head
Humans
Lower Extremity
Neck
Nerve Block
Neuralgia
Pain Clinics
Psychiatry
Recurrence
Spinal Cord Stimulation*
Spinal Cord*
Splints
Stress, Psychological
Upper Extremity