Complex regional pain syndrome (CRPS) type-1 following snake bite: a case report

The pathophysiological mechanism and clinical course of complex regional pain syndrome (CRPS) type-I still remain ill defined. Both the treatment and the prediction of the outcome of the treatment are difficult. Abnormal neurohumoral and inflammatory mechanisms have been implicated in its causation usually following trivial noxious event in an extremity. However, to the best of our knowledge CRPS type-1 following snakebite has not been reported yet in the literature. We here report a case of an aggressive CRPS type-1 following a mountain pit viper bite, locally known as Gurube (Ovophis monticola monticola) in a 55-year-old lady. The clinical condition responded well to the therapy with serial sympathetic blockade of the limb with local anaesthetics, non-steroidal antiinflammatory analgesic, antiepileptic, antidepressant and physiotherapy. Our experience in managing this patient and associated pathophysiology in development of CRPS type-1 are discussed.