Complex regional pain syndrome type II after cervical transforaminal epidural injection: A case report

Medicine
Gi-Young ParkDae Gil Kwon

Abstract

We report a case of a 61-year-old patient who developed complex regional pain syndrome (CRPS) type II after a cervical transforaminal epidural steroid injection (CTESI). The patient developed sudden-onset severe pain and swelling of his upper right limb after a cervical transforaminal epidural injection. On physical examination, the patient's symptoms and signs corresponded to the Budapest criteria for CRPS. Cervical magnetic resonance imaging and laboratory tests were performed to rule out other causes. An electrodiagnostic study revealed right C6/7 radiculopathies. A three-phase bone scan showed increased uptake in the right wrist in all phases. Thus, he was diagnosed with CRPS type II due to a cervical nerve root injury caused by the transforaminal epidural injection. He received oral methylprednisolone and gabapentin, and underwent physical therapy for 9 days. The pain and swelling of his right upper limb disappeared and he returned to his previous functional activities. CRPS type II due to cervical root injury is rare but can develop during CTESI. Early comprehensive physical therapy and oral medications might result in good outcomes.

References

Mar 4, 2006·The Clinical Journal of Pain·Christian SchinkelMatthias Schuermann
Jan 28, 2014·The Journal of Pain : Official Journal of the American Pain Society·Frank BirkleinWade S Kingery
Jul 2, 2014·Neurologia i neurochirurgia polska·Andrzej Żyluk, Piotr Puchalski
Aug 13, 2015·Best Practice & Research. Clinical Rheumatology·Roberto CasalePiercarlo Sarzi-Puttini

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