A Case of Reflex Sympathetic Dystrophy in Response to Trivial Injury with Delayed Onset

J Korean Neurol Assoc > Volume 16(6); 1998 > Article

Journal of the Korean Neurological Association 1998;16(6): 897-898.

사소한 외상 후 지발성으로 발생한 반사성 교감신경성 이영양증 1례

이승한, 조연희·김인규·김명규·조기현·김세종

전남대학교 의과대학 신경과학교실

A Case of Reflex Sympathetic Dystrophy in Response to Trivial Injury with Delayed Onset

Seung-Han Lee, M.D., Yeon-Heui Cho, M.D., In-Gyu Kim, M.D., Myeong-Kyu Kim, M.D., Ki-Hyun Cho, M.D., Sei-Jong Kim, M.D.

Department of Neurology, Chonnam National University Medical School

Abstract

A 16-year-old-girl was admitted to Chonnam University Hospital because of severe burning pain and allodynia in the toe and heel of the left foot that persisted for 2 months. She had a remote history of repeatedly spraining her ankle. She had experienced severe spontaneous burning pain, hyperalgesia, and allodynia associated with a edematous red-hot foot which was relieved by immersing the limb in ice water. The pain was aggravated by numorous somatosensory, emotional and psychologic factors. A neurological examination on admission showed muscular wasting and hypesthesia in the left lower leg. Plain radiographs of the feet revealed osteoporotic lesions and triple-phase bone scan showed an increased uptake in the affected limb. Thermograms of the patients showed a reduction in temperature of about 10C in the affected limb compared with the unaffected limb. A regional sympathetic blockade was attempted with unsuccessful results. We report that a case of RSD seemingly to have been delayed at its onset after repeated minor trauma. Keyword: Reflex sympathetic dystrophy, Delayed onset, Trivial injury, Sympathetic blockade