PEDIATRICS Vol. 82 No. 5 November 1988, pp. 728-732
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Reflex Sympathetic Dystrophy in Children: Treatment With Transcutaneous Electric Nerve Stimulation

Richard W. Kesler MD1, Frank T. Saulsbury MD1, Lee T. Miller MD1, and John C. Rowlingson MD1

1 From the Departments of Pediatrics and Anesthesia, University of Virginia Medical Center, Charlottesville

During the past 6 years, ten children with reflex sympathetic dystrophy were treated. Pain in an extremity was the initial complaint in all patients. The pain was unilateral in 90% of the patients; upper and lower extremities were affected with equal frequency. Tenderness to palpation, extreme hyperesthesia, and dysesthesia were other dominant features. All patients had some evidence of autonomic nervous system dysfunction in the affected extremity (swelling, color change, decreased temperature, and/or hyperhidrosis). The median duration of symptoms prior to referral and diagnosis was 5 months. All children were treated as outpatients with a transcutaneous electric nerve stimulator and homebased physical therapy. With this regimen, seven patients had complete remission within 2 months. Two other patients improved with transcutaneous electric nerve stimulation therapy, and one patient had no response to transcutaneous electric nerve stimulation. Reflex sympathetic dystrophy is frequently underdiagnosed in children. Increased awareness of this syndrome is important because accurate diagnosis is crucial and transcutaneous electric nerve stimulation offers a safe, simple, and effective outpatient therapy for reflex sympathetic dystrophy in children.

Key Words: transcutaneous electric nerve stimulation • reflex sympathetic dystrophy

Submitted on January 29, 1987
Accepted on October 6, 1987




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