Girl aged 11 years at the time of diagnosis of left ankle sprain treated in Paediatric Traumatology. She was diagnosed with CRPS of the left ankle and foot by Paediatric Rheumatology and started pharmacological treatment; as she did not obtain relief she was referred to the Pain Unit.
She was first treated pharmacologically without obtaining adequate pain relief, so it was decided (with prior information and parental consent) to implant, in the operating theatre and under general anaesthesia, a lumbar epidural catheter, initiating, through it, a continuous infusion of local anaesthesia for two weeks. During this time, pain relief was total, but ceased when the local anaesthesia was stopped. For this reason it was decided (with prior information and parental consent) to implant, in the operating theatre and under general anaesthesia, an octopolar electrode in the posterior medullary cords for stimulation of the left leg. The system was programmed once the patient was awake, achieving a very good localisation of the paraesthesias. Two weeks later, the patient was reviewed and continued to respond well to pain and other symptoms, so it was decided to implant an implantable and programmable pulse generator and connect it to the electrode. At present, she continues to be treated with spinal cord stimulation with total remission of the condition.