Treating CRPS and FNSD in an Adolescent: A Case Study

Area of Science:

• Pain Medicine
• Neurology
• Psychiatry

Background:

• Complex Regional Pain Syndrome (CRPS) is a debilitating pain disorder.
• Functional Neurological Symptom Disorder (FNSD) can co-occur with CRPS.
• The efficacy of treatments for comorbid CRPS and FNSD is not well-established.

Purpose of the Study:

• To describe the first case of a 15-year-old female with comorbid CRPS and FNSD treated with peripheral nerve catheters (PNCs) and interdisciplinary therapy.
• To examine the short- and long-term impact of PNC-augmented interdisciplinary treatment and subsequent psychotherapy.

Main Methods:

• A 15-year-old female with comorbid CRPS and FNSD underwent a PNC-augmented interdisciplinary pain program.
• Following the program, the patient received outpatient psychotherapy.
• Outcomes were assessed for both CRPS and FNSD symptoms and overall functioning.

Main Results:

• PNC-augmented interdisciplinary treatment led to CRPS symptom resolution and initial FNSD improvement.
• FNSD symptoms recurred post-discharge with a different presentation.
• Subsequent psychotherapy reduced FNSD episode frequency and improved functioning.

Conclusions:

• Brief interdisciplinary treatment with PNCs may benefit CRPS but is insufficient for long-term FNSD management.
• Psychotherapy is crucial for sustained recovery in patients with comorbid CRPS and FNSD.
• Longer-term interdisciplinary or psychological interventions are essential for functional restoration in these patients.