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  4. Bilateral Upper Limb Complex Regional Pain Syndrome (Type 2) in Cervical Spinal Cord Injury: A Case Report

Bilateral Upper Limb Complex Regional Pain Syndrome (Type 2) in Cervical Spinal Cord Injury: A Case Report

Cureus, 2022 · DOI: 10.7759/cureus.26440 · Published: June 29, 2022

NeurologyPain ManagementRehabilitation

Simple Explanation

Complex Regional Pain Syndrome (CRPS) is a condition causing pain, often linked to nerve damage. This report describes a case where a patient developed CRPS in both arms after a spinal cord injury. The patient, who had a history of heart issues and cervical spondylosis, experienced a fall and subsequent spinal cord injury, leading to CRPS in his upper limbs. The patient underwent inpatient rehabilitation, including physical and occupational therapy, along with steroid treatment, which improved his condition.

Study Duration
3 weeks
Participants
One 68-year-old man
Evidence Level
Case Report

Key Findings

  • 1
    A 68-year-old man developed bilateral upper limb CRPS (Type 2) following a traumatic central cord syndrome after a fall.
  • 2
    Triphasic bone scan (TPBS) confirmed the diagnosis of CRPS with symmetrical increased radiotracer activity in both hands.
  • 3
    The patient's symptoms and functional ability improved after three weeks of steroids and inpatient rehabilitation, including improvements in precision grip.

Research Summary

This case report describes a rare instance of bilateral CRPS following a central cord syndrome, highlighting the diagnostic and management complexities. The diagnosis of CRPS was confirmed using a triphasic bone scan, which showed symmetrical increased radiotracer activity in both hands. Multimodal management, including corticosteroids and inpatient rehabilitation, led to improved symptoms and functional ability in the patient.

Practical Implications

Early Diagnosis

Prompt diagnosis and referral to rehabilitation medicine can aid in early treatment, addressing pain and functional impairments.

Multimodal Management

Effective management of bilateral CRPS requires a multimodal approach, including pharmacological interventions, physical and occupational therapy, and physical modalities.

Awareness Among Physicians

This case highlights the importance of raising awareness among physicians regarding the diagnostic and treatment complexities of CRPS when it presents bilaterally.

Study Limitations

  • 1
    Single case report limits generalizability
  • 2
    Lack of controlled comparison group
  • 3
    Limited long-term follow-up data

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