title: Pathophysiology of the spreading of complex regional pain syndrome revisited: a case report.
abstract: OBJECTIVE
  To determine if there is a relationship in our patient developing complex regional pain syndrome from a jellyfish and its subsequent spread to the contralateral side.
  
  
  METHODS
  Data bases were searched using PubMed and Ovid. Keywords searched include "complex regional pain syndrome,""jelly fish," and "pathophysiology."
  
  
  RESULTS
  This patient was successfully treated with a spinal cord stimulator implantation with bilateral lead placement at thoracic spine (T9) stimulating her lower extremities in addition to the leads that had already been placed in her cervical spine for her upper extremities.
  
  
  CONCLUSIONS
  Definite knowledge of the pathophysiology of complex regional pain syndrome would allow better identification of risk factors for the development of this condition after trauma. This patient is at higher risk of developing complex regional pain syndrome and should avoid surgeries (such as knee and wrist surgeries) and high risk physical activities.
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA. pari.azari@gmail.com
authors.forename: Pari
authors.initials: P
authors.lastname: Azari
authors.forename: Yan
authors.initials: Y
authors.lastname: Lu
authors.forename: Colin F M
authors.initials: CF
authors.lastname: Clarke
authors.forename: Timothy
authors.initials: T
authors.lastname: Collins
authors.forename: Dean
authors.initials: D
authors.lastname: Briones
authors.forename: Billy
authors.initials: B
authors.lastname: Huh
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000150:complications*; D020918:Complex Regional Pain Syndromes / Q000209:etiology* / Q000503:physiopathology* / Q000628:therapy*; D016208:Databases, Factual; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008875:Middle Aged; D037401:Scyphozoa; D016896:Treatment Outcome