Das komplexe regionale Schmerzsyndrom bei Kindern

Abstract

While complex regional pain syndrome (CRPS) is a well-established entity in adults, its occurrence in children was doubted for a long time. However, in the last few years several case reports and some comparative studies have described CRPS in children and adolescents. In contrast to adults most of the involved children are female, suffering from CRPS after an initial event that is typically a minor trauma. Furthermore, CRPS occurs more frequently in the lower extremity than in the upper extremity when compared to adults. Since neither radiological findings nor laboratory parameters are able to confirm CRPS, the diagnosis is made from a detailed description of the clinical signs and symptoms characterized by a remarkable intra- and inter-individual variability. The treatment concept is comprised of intensive physical therapy, pain management and psychological therapy, physical therapy having the major impact. In spite of a sometimes long and variable clinical course the prognosis in most cases is excellent and usually results in complete functional restoration. Nevertheless, relapses are described in up to 30% and can involve other locations or present in a different fashion regarding clinical symptoms.