Complex regional pain syndrome type I in children. Clinical description and quality of life

Bayle-Iniguez, Xavier; Audouin-Pajot, C.; Gauzy, Jérôme Sales de; Munzer, Caroline; Murgier, Jérôme; Accadbled, Franck

doi:10.1016/j.otsr.2015.06.013

Cited by 21 publications

(23 citation statements)

References 20 publications

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“…The precise cellular mechanisms underlying CRPS remain elusive; however, we know it to be a highly incapacitating chronic pain syndrome. A history of physical trauma and psychosocial stressors has been identified as a risk factor for CRPS in pediatric patients 5 . Iniguez et al found that 49% of pediatric patients with CRPS had experienced physical trauma, and 51% reported at least 1 psychosocial stressor 5 .…”

Section: Discussionmentioning

confidence: 99%

“…A history of physical trauma and psychosocial stressors has been identified as a risk factor for CRPS in pediatric patients 5 . Iniguez et al found that 49% of pediatric patients with CRPS had experienced physical trauma, and 51% reported at least 1 psychosocial stressor 5 . Furthermore, quality of life in pediatric patients with CRPS type I has been assessed using the Pediatric Quality of Life (PEDS QL) 4‐0 score, revealing significantly lower scores than the control group regarding physical, psychosocial, social, and emotional aspects, sparing the school performance, which was found to be unaffected 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Compared to healthy peers, children and adolescents with CRPS type I were statistically more likely to have anxiety, perfectionism, good school performance, sleep difficulties, and chronic headache, with anxiety being the most significant association. Worsening symptom severity and progression of disease creates physical limitations; this constellation has a detrimental effect on all aspects of quality of life, including emotional, social, psychosocial, and physical subsets 5 . As the pain and disability becomes a disease unto itself, psychiatric comorbidities that preceded CRPS can become amplified 5 or new psychiatric disorders may develop.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with CRPS are often frequently misdiagnosed despite presenting at many clinic and emergency department (ED) visits with catastrophic pain crises, ultimately leading to delays in diagnosis of 14.2 months on average 5 . Loss of ambulatory function, difficulty sleeping due to pain, and pain‐related anxiety can prevent the patient from living an independent life, leading to higher levels of distress affecting the individuals and their families 5 …”

Section: Introductionmentioning

confidence: 99%

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Spinal Cord Stimulation Improves Functional Outcomes in Children With Complex Regional Pain Syndrome: Case Presentation and Review of the Literature

et al. 2020

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Background: In the pediatric population, complex regional pain syndrome (CRPS) is a debilitating chronic pain syndrome that is classically treated with escalating polypharmacy and physical therapy. Failure of therapy is often encountered in both adult and pediatric patients with CRPS, after which invasive neuromodulatory therapy might be considered. Intrathecal drug delivery systems and spinal cord stimulation (SCS) have been reported in the literature as forms of neuromodulation effective in adult CRPS; however, SCS remains inadequately researched and underreported in the pediatric CRPS population. Owing to the differences in patient population characteristics and the specific vulnerability of adolescents to drugs that might be used to manage refractory cases, including but not limited to opioids, we believe that early effective pain management without the use of chronic pain medications is of paramount importance. Methods: Recent evidence suggests that neuromodulation can be useful toward improving function and managing pain, while also reducing medication use in chronic pain patients. A representative case a review of the literature is performed. Results: We report the effective treatment of CRPS in a pediatric patient following implantation of an SCS device typifying the improved pain scores, decreased medication use, and substantially improved functional abilities in pediatric patients following SCS. Conclusions: The manuscript objective is to stimulate a discussion for SCS use earlier in the therapeutic management of CRPS in children. &

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spinal Cord Stimulation Improves Functional Outcomes in Children With Complex Regional Pain Syndrome: Case Presentation and Review of the Literature

et al. 2020

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“…Physical functioning was not assessed by medical provider evaluation, but by parental survey. The PedsQL™ is an inventory not approved specifically for OI, but has been used in other chronic pediatric disease-specific populations [ 28 , 29 ]. The FACES® scale used to evaluate pain is not specific for a population with OI; unfortunately, there is no pain assessment available specifically for children and adolescents with OI [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Cyclic bisphosphonate therapy reduces pain and improves physical functioning in children with osteogenesis imperfecta

Garganta

Jaser

Lazow

et al. 2018

BMC Musculoskelet Disord

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BackgroundChildren with osteogenesis imperfecta (OI) experience pain and impaired physical functioning. The longitudinal effect of cyclic bisphosphonate treatment on these symptoms has not been described. We serially evaluated pain and functioning in pediatric patients with OI treated with intravenous bisphosphonate therapy.MethodsPain and physical functioning were assessed at multiple time-points over two infusion cycles in 22 OI patients (median age 10 years [range 2–21 years]; 8 girls) receiving cyclic intravenous bisphosphonate therapy. Pain was assessed using the FACES® visual analogue scale; physical functioning, including self-care, was assessed using the PedsQL™ Generic Core inventory.ResultsPain scores decreased significantly immediately following infusion and remained reduced at 4 weeks post-infusion, increasing before and decreasing again after subsequent infusion (F = 25.00, p < 0.001). Physical functioning scaled scores improved 4 weeks after infusion and declined before subsequent infusion across patients (F = 10.87, p = 0.007). Exploratory analyses indicated significantly different effects between mild and moderate-severe OI types for pain, but not for physical functioning. No fractures occurred during the study.ConclusionIn children with OI, cyclic intravenous bisphosphonate therapy transiently reduces pain and improves functional abilities. Pain relief occurs immediately following infusion with functional improvements observed 4 weeks later. Both pain and physical functioning return to pretreatment levels by the subsequent infusion.

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Children and Adolescents with CRPS

Lee

Shah

2021

Complex Regional Pain Syndrome

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Complex regional pain syndrome type I in children. Clinical description and quality of life

Abstract: IV.

Cited by 21 publications

References 20 publications

Spinal Cord Stimulation Improves Functional Outcomes in Children With Complex Regional Pain Syndrome: Case Presentation and Review of the Literature

Spinal Cord Stimulation Improves Functional Outcomes in Children With Complex Regional Pain Syndrome: Case Presentation and Review of the Literature

Cyclic bisphosphonate therapy reduces pain and improves physical functioning in children with osteogenesis imperfecta

Children and Adolescents with CRPS

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