Clinical Features of Pediatric Complex Regional Pain Syndrome

Abstract

Objectives: Complex regional pain syndrome (CRPS) is a painful condition of a limb characterized by a constellation of symptoms. Little is known about the clinical features of pediatric CRPS, with fewer than a dozen studies published to date. The aim of this study was to explore the clinical course of pediatric CRPS, with emphasis on clinical features and disease outcomes. A secondary aim was to discern differences in clinical features of pediatric CRPS with and without related movement disorders, and between children who had a favorable and unfavorable outcome. Materials and Methods: We carried out a retrospective chart review of children with CRPS who presented to a pediatric Chronic Pain Clinic in Canada over a 5-year period (2012 to 2016). Results: The study identified 59 children with CRPS (mean age: 12.7±2.5; 74.6% female; 72.9% lower extremity). In total, 87% (n=48) of children experienced complete resolution or significant improvement of CRPS, with a relapse rate of 15%. Overall, 25% (n=15) had a CRPS-related movement disorder. There were no differences in the clinical features of pediatric CRPS with or without related movement disorders. Children who experienced a favorable outcome had a significantly shorter symptom duration at the initial visit in comparison with children who experienced an unfavorable outcome. Discussion: In this cohort, pediatric CRPS was most common in girls around the age of 12, usually in the lower extremity, and most experienced a favorable outcome. Further research is needed to better understand the prognosis and relapse rate of pediatric CRPS.

Impact of adolescent complex regional pain syndrome on the psychopathology of young men ahead of military service: a retrospective cohort analysis of Korean conscription data

“…The onset age of CRPS symptoms among our subjects ranged from 13 to 19 years, and the mean pain duration was 27.41 ± 2.67 months. The age and pain duration of the participants in the current study differed from that in previous studies by Logan et al [33] and Mesaroli et al [34], but the key results are generally consistent.…”

“…The mean symptom duration was 35.7 ± 43.8 weeks. Their investigation using self-report questionnaires showed that anxiety, depression, and somatization were within normal ranges relative to age-and sex-matched peers [34]. However, through clinical diagnostic interviews, 39% of patients were diagnosed as having anxiety disorders, 12% had depressive disorders, 13% had somatic symptom disorders, and 37% had some type of past adverse events.…”

“…Mesaroli et al [34] retrospectively reviewed the charts of 59 CRPS patients with a mean age of 13.2 ± 2.6 years. The mean symptom duration was 35.7 ± 43.8 weeks.…”

“…Adolescent and pediatric CRPS have been associated with unique gender ratios [7,8,34]. CRPS is approximately 3 to 6 times more common among girls than boys [7,8,34].…”

“…Adolescent and pediatric CRPS have been associated with unique gender ratios [7,8,34]. CRPS is approximately 3 to 6 times more common among girls than boys [7,8,34]. The study sample investigated by Table 3 Comparison of demographics and pain characteristics between the two complex regional pain syndrome (CRPS) groups according to pain duration mCSS Modified Complex regional pain syndrome Severity Score, NRS Numerical rating scale, CRPS Complex regional pain syndrome Mesaroli et al [34] was also predominantly composed of females (74.6%), and as previously mentioned, psychopathologic features were detected via clinical diagnostic interviews.…”