Departments of Rehabilitation.
Departments of Physical Therapy.
Clin J Pain. 2019 Dec;35(12):933-940. doi: 10.1097/AJP.0000000000000759.
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.
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).
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.
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.
复杂性区域疼痛综合征(CRPS)是一种肢体疼痛病症,其特征是一系列症状。目前对于儿科 CRPS 的临床特征知之甚少,迄今为止发表的研究不足十余项。本研究旨在探讨儿科 CRPS 的临床病程,重点关注临床特征和疾病结局。次要目的是辨别伴有或不伴有相关运动障碍的儿科 CRPS 的临床特征差异,以及具有良好和不良结局的儿童之间的差异。
我们对在加拿大一家儿科慢性疼痛诊所就诊的 5 年内(2012 年至 2016 年)患有 CRPS 的儿童进行了回顾性图表审查。
该研究确定了 59 名患有 CRPS 的儿童(平均年龄:12.7±2.5;74.6%为女性;72.9%为下肢)。总的来说,87%(n=48)的儿童的 CRPS 完全缓解或显著改善,复发率为 15%。总体而言,25%(n=15)的儿童有 CRPS 相关运动障碍。伴有或不伴有相关运动障碍的儿科 CRPS 的临床特征无差异。与不良结局的儿童相比,具有良好结局的儿童在初次就诊时的症状持续时间明显更短。
在本队列中,儿科 CRPS 最常见于 12 岁左右的女孩,通常发生在下肢,大多数儿童的结局良好。需要进一步研究以更好地了解儿科 CRPS 的预后和复发率。