Demography and Treatment of Complex Regional Pain Syndrome Among Children

摘要

Introduction: Complex Regional Pain syndrome (CRPS) is a rare chronic pain syndrome characterized by amplified pain and autonomic dysfunction. A systematic multidisciplinary treatment program for affected children exists at our department. This study aims to estimate the incidence of CRPS and describe the demography, symptoms and psychosocial characteristics of the patients and evaluate the treatment results. Method: A retrospective medical chart review of all patients under the age of 16 years treated for CRPS between 2004 and 2014 at Hans Christian Andersen Children Hospital. Results: A total of 29 children fulfilled the diagnostic criteria for CRPS. The mean incidence was 2,4/100.000 children per year. Most patients were girls (90%) with a median age of 11 years. A lower extremity was most often involved (86%). Time to diagnosis had a mean of 174 days. All patients reported complete disappearance or significant reduction of pain at discharge without any medication. Walking was normalized in 75% and almost 1/3 could run normally. School attendance and social life was restored. Conclusion: The typical child with CRPS is a girl of normal stature, around 11 years old, who is affected by intolerable pain in a lower extremity and has severe limitation in walking. The condition is rare with a mean incidence of 2,4/100.000 children. Attention is important in order to reduce the diagnostic delay. Our treatment program was successful as the children were in reduced pain, gaining normal physical function and out of social isolation at completion of the program.