Abstract
We described an 11-year-old boy with reflex sympathetic dystrophy (RSD). He presented symptoms of allodynia and hyperesthesia in the right foot with pale color and coldness. Before the onset he had abdominal pain and a change of taste.
The symptoms were resistant to physical therapy and the right foot became atrophic. Intermittent lumber epidural anesthesia by an indwelling catheter was performed for three weeks after 5 months from the onset. Improvement of symptoms did not occur during the anesthesia, but did soon after that.
The pathogenesis of RSD remains unknown, although a psychological factor may have been involved in this case. RSD in childhood is usually considered to be more responsive to conservative therapy. However, some children such as our patient are resistant to conservative therapy. Recognition of RSD and early interventions such as physical therapy and psychological approach are important. In intractable cases invasive approaches such as sympathetic blockade should be also considered.
