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Reflex sympathetic dystrophy: an underreported syndrome in children?
R A Lemahieu1, C Van Laere, L A Verbruggen
1Department of Pediatrics, Akademisch Ziekenhuis Vrije Universiteit Brussel, Belgium.
European Journal of Pediatrics
|January 1, 1988
Summary
Reflex sympathetic dystrophy (RSD) in children presents differently than in adults. Bone scintigraphy may show decreased uptake, and nerve conduction studies can reveal slower velocities, with varied treatment responses.
Area of Science:
- Pediatric neurology
- Pain management
- Skeletal imaging
Background:
- Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome, is a poorly understood condition.
- While common in adults, pediatric cases are less frequently reported and may exhibit distinct clinical and diagnostic features.
Observation:
- Two pediatric patients, aged 10 and 13, presented with symptoms suggestive of RSD.
- The 10-year-old experienced symptoms sequentially in her right leg, left foot, and left hand.
- Diagnostic imaging and electrophysiological tests were performed to evaluate the affected limbs.
Findings:
- Unlike typical adult presentations, bone scintigraphy in the early phase revealed decreased radio-isotope uptake in affected areas for the 10-year-old.
- Electromyography in the 13-year-old indicated slower nerve conduction velocity in the affected limb.
- These findings highlight potential differences in the pathophysiology or diagnostic markers of pediatric RSD.
Implications:
- The distinct imaging and electrophysiological findings in children suggest a need for age-specific diagnostic criteria for RSD.
- The 13-year-old improved with physical therapy and calcitonin, while the 10-year-old responded well to sympathetic blockade, indicating varied therapeutic responses.
- Further research is warranted to elucidate the unique aspects of pediatric RSD and optimize treatment strategies.