Tratamiento del SDRC en niños mediante estimulación eléctrica medular

Abstract

Introduction: The IASP defined CRPS as "pain box disproportionate to the cause that produces it, accompanied by sensory disturbances such as allodynia/hyperalgesia, autonomic and motor dysfunction that occurs after a trauma that often is trivial andi s presents ussually a limb". These symptoms are well described in adults, but there are few data on the prevalence in the pediatric population. Unlike the adult, 90% of cases occur in girls aged between 8-16 years with involvement mainly of a lower limb. Materials and methods: We present a total of two patients, aged 11 and 13 years old with severe symptoms of lower extremity CRPS, previously treated with medication and rehabilitation without relief from their symptoms. In the two patients underwent continuous lumbar sympathetic block by placing on epidural catheter and administration of a continuous infusión of local anesthetic, so the patient improved both pain and the resto f the accompanying symptoms. Was implanted in the operating room under general anesthesia octupole electrode starting at dorsal epidural electrical stimulation of the affected limb. In the two patients was evaluated both the evolution of the intensity of pain and its impacto n quality of life befote the Honest of stimulation and within two weeks of starting treatment, at which time it terminated the period of proceeded to test the implementation (in the operating room under general anesthesic) programmable generator.

Síndrome de dolor regional complejo en niños: posibilidades de tratamiento

“…El electrodo se situó a nivel de las metámeras T8-T10. Una vez que las niñas se recuperaron de la anestesia se inició la estimulación eléctrica obteniéndose un buen nivel de parestesias con remisión del dolor y del resto de los síntomas acompañantes (42). La estimulación eléctrica medular es una técnica invasiva cuya utilización puede recomendarse en aquellos casos se haya mostrado insuficiente la aplicación del resto del algoritmo de tratamiento (43).…”