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 "Complex regional pain syndrome in adults: Pathogenesis, clinical manifestations, and diagnosis" and "Complex regional pain syndrome in adults: Prevention and management".)
Alternative names for 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