title: Complex regional pain syndrome following protracted labour*.
abstract: Obstetric nerve palsies are common and long-term sequelae are fortunately rare. The development of a complex regional pain syndrome is an unusual and less reported complication of labour-related neuropathy. A 28-year-old primigravida who experienced prolonged labour and instrumental delivery under spinal anaesthesia complained of persisting weakness and numbness postpartum, affecting the left lower limb. Urgent magnetic resonance imaging demonstrated no abnormality and a common peroneal nerve injury was later confirmed by nerve conduction studies. Unfortunately, the neuropathy did not resolve as expected and oedema, burning paraesthesia and allodynia affecting the left foot developed within two weeks. She was treated with gabapentin, ibuprofen, topical capsaicin and regular physiotherapy. After six months, the foot drop had resolved and the chronic pain element was significantly diminished.
authors.affiliation: Department of Anaesthesia, Norfolk & Norwich University Hospital, Norwich, Norfolk, UK. angusbutchart@doctors.org.uk
authors.forename: A G
authors.initials: AG
authors.lastname: Butchart
authors.forename: M
authors.initials: M
authors.lastname: Mathews
authors.forename: A
authors.initials: A
authors.lastname: Surendran
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D020918:Complex Regional Pain Syndromes / Q000209:etiology*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D018908:Muscle Weakness / Q000209:etiology; D007744:Obstetric Labor Complications / Q000503:physiopathology*; D009788:Occupational Therapy; D010149:Postoperative Pain / Q000628:therapy; D010292:Paresthesia / Q000209:etiology; D059348:Peripheral Nerve Injuries; D026741:Physical Therapy Modalities; D011247:Pregnancy
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal