Delayed sympathetically maintained pain caused by electrical burn at the current's entry and exit sites

It is not uncommon for sympathetically maintained pain (SMP) to follow electric burns at the site of current entry. The occurrence of SMP at the exit point has not been reported. This report describes a patient who was exposed transiently to a 220W electrical current. After a delay of 3 months, the typical manifestations of SMP appeared on the right hand (entry point); symptoms appeared on the left foot (exit point) after 11 months. Ultrasonography was helpful in identifying the bony and soft tissue changes that occurred with SMP. Serial sympathetic blocks, oral phenytoin, and an intensive physical rehabilitation program were useful in treating this electrically induced SMP.