Complex regional pain syndrome in children
- David D Sherry, MD
David D Sherry, MD
- Professor of Pediatrics
- University of Pennsylvania
- Section Editors
- Thomas JA Lehman, MD
Thomas JA Lehman, MD
- Section Editor — Pediatric Rheumatology
- Professor of Clinical Pediatrics
- Cornell University Medical College
- Marc C Patterson, MD, FRACP
Marc C Patterson, MD, FRACP
- Section Editor — Pediatric Neurology
- Professor of Neurology, Pediatrics, and Medical Genetics
- Chair, Division of Child and Adolescent Neurology
- Mayo Clinic College of Medicine
Complex regional pain syndrome (CRPS) is an amplified musculoskeletal pain syndrome that is characterized by extreme pain in a limb out of proportion to the history and physical findings, accompanied by one or more signs of autonomic dysfunction . Although CRPS was first reported in 1864 , it was not until 1971 that CRPS was described in a child . Since the initial pediatric report, CRPS is increasingly recognized in pediatric pain, rheumatology, and neurology clinics [4-6].
The clinical manifestations, diagnosis, and management of CRPS in children are reviewed here. CRPS in adults is discussed separately. (See "Etiology, clinical manifestations, and diagnosis of complex regional pain syndrome in adults" and "Prevention and management of complex regional pain syndrome in adults".)
Alternative names for complex regional pain syndrome (CRPS) in the literature include reflex sympathetic dystrophy (RSD), algodystrophy, causalgia, Sudeck atrophy, transient osteoporosis, and acute atrophy of bone. In 1995, a consensus conference grouped these disorders under a single heading of CRPS .
CRPS is divided into two categories:
●Type I occurs in patients with CRPS without a definable nerve lesion.
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- Childhood versus adult CRPS
- Local factors
- Role of the central nervous system
- - Psychologic issues
- Genetic predisposition
- CLINICAL MANIFESTATIONS
- Autonomic dysfunction
- Sleep disturbances
- Psychologic findings
- Other findings
- Laboratory studies
- - Blood tests
- - Imaging studies
- Other studies
- DIFFERENTIAL DIAGNOSIS
- Physical and occupational therapy
- Psychologic and behavioral therapy
- Pharmacologic therapy
- Pain-reducing procedures
- Our approach
- Primary care
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS