Recurrent migratory sympathetically maintained pain syndrome in a child: a case report.
A 10-year-old boy presented with pain and swelling of short duration in his right hand. A traumatic cause was ruled out. He had clinical features suggestive of sympathetic overactivity in the form of hyperesthesia, edema and dry skin. The results of a few baseline investigations performed at this stage were all within normal limits. A provisional diagnosis of sympathetically maintained pain syndrome (SMPS) was made. He responded dramatically to a stellate ganglion block. His symptoms recurred within 3 weeks, though now in the lower limb. Again the clinical features were consistent with SMPS. His response to a lumbar sympathetic block was again dramatic. This case illustrates that the diagnosis of SMPS is essentially clinical and that prompt diagnosis and treatment with sympathetic blocks can be very rewarding.
Agarwal
Vineet
V
Pediatric Orthopedic Service, Kasturba Medical College, Manipal, Karnataka, India.
Joseph
Benjamin
B
D001340:Autonomic Nerve Block; D002648:Child; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy