An 8-year-old girl suffers a left ankle sprain. She is diagnosed with CRPS of the left ankle and foot which resolves completely within a couple of weeks with medical treatment.
Two months later, and without any previous trauma, she began to experience pain in her right ankle and foot, which was also diagnosed as CRPS. She was referred to the Pain Unit by the Paediatric Trauma Service two months after this diagnosis.
Treatment was started with pregabalin plus tramadol, plus the application of an 8% capsaicin patch due to the severe allodynia she presented, without obtaining adequate relief of either the pain or the rest of the accompanying symptomatology.
It was therefore decided (with parental consent) to implant a lumbar epidural catheter in the operating theatre under general anaesthesia and connect it to an external pump to administer a continuous infusion of bupivacaine for two weeks, after which time the infusion was stopped and the catheter removed. Complete remission of symptoms continues.