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Recurrent and migratory reflex sympathetic dystrophy in children.
1Department of Physical Medicine and Rehabilitation, University of Michigan Health Systems, Ann Arbor 48108, USA. hct@groupwise.med.umich.edu
Pediatric Rehabilitation
|July 27, 2001
Summary
Reflex sympathetic dystrophy (RSD) in children can occur without trauma, presenting as recurrent and migratory pain. Early intervention with epidural anesthesia, physical therapy, or stellate ganglion blocks may be effective.
Area of Science:
- Pediatric Rehabilitation
- Pain Management
- Neurology
Background:
- Reflex sympathetic dystrophy (RSD) is a rare condition in children, typically considered benign and self-limiting.
- It is characterized by pain, swelling, vasomotor instability, and skin changes.
Observation:
- An 11-year-old girl with no trauma history presented with spontaneous leg pain, diagnosed as RSD.
- She experienced recurrent, migratory RSD in her arms over five years, refractory to initial treatments.
Findings:
- Initial oral medication was unsuccessful; symptoms resolved with epidural anesthesia and physical therapy.
- Recurrent episodes required multiple stellate ganglion blocks for resolution.
- The third recurrence was refractory to stellate ganglion blocks but resolved with gabapentin.
Implications:
- This case highlights that pediatric RSD can be non-traumatic, recurrent, and migratory.
- It underscores the need for diverse treatment strategies beyond conservative management.
- Gabapentin may be a viable option for refractory pediatric RSD cases.