The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Cervical and Thoracic Spinal Cord Stimulation in a Patient with Pediatric Complex Regional Pain Syndrome -A case report-

소아 복합부위통증증후군 환자에서 경부와 흉부 척수 자극술 -증례보고-

  • Park, Jung Ju (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Moon, Dong Eon (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Seung Jae (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Choi, Jung Il (Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School) ;
  • Shim, Jae Chol (Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University)
  • 박정주 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 문동언 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 박승재 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 최정일 (전남대학교 의과대학 마취통증의학교실) ;
  • 심재철 (한양대학교 의과대학 마취통증의학교실)
  • Received : 2006.10.11
  • Accepted : 2007.03.28
  • Published : 2007.06.30
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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. (Korean J Pain 2007; 20: 60-65)

Keywords

References

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