交通外傷後に上肢CRPS type I を呈した外傷性頸部症候群の1例

  • 永尾 勝
    First Department of Anesthesiology, Dokkyo University School of Medicine
  • 奥田 圭子
    First Department of Anesthesiology, Dokkyo University School of Medicine
  • 濱口 眞輔
    First Department of Anesthesiology, Dokkyo University School of Medicine
  • 見塩 六生
    First Department of Anesthesiology, Dokkyo University School of Medicine
  • 奥田 泰久
    First Department of Anesthesiology, Dokkyo University School of Medicine
  • 北島 敏光
    First Department of Anesthesiology, Dokkyo University School of Medicine

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  • A Case of CRPS Type I in the Upper Extremity after Traffic Accident

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Presented is a 48-year-old man who had complex regional pain syndrome (CRPS) Type I in the left upper extremity after a car accident. There were no abnormal MRI images associated with the traffic accident. Two years later he was admitted to a local hospital and diagnosed as having whiplash injury. He received medication and physical therapy, but his symptoms did not improve. He was referred to our clinic 2 years ago. He complained of burning pain in his left upper extremity which was evaluated at 80-mm of visual analogue scale (VAS). He also had edema, hyperpathia, allodynia, coldness, and cyanosis in his left hand. However, there was no headache, vertigo, tinnitus nausea, or memory loss. Therefore, the diagnosis of CRPS Type I was made. The patient received left stellate ganglion block 20 times, which reduced his VAS from 80-mm to 40-mm, and he resumed working thereafter. The cause of CRPS type I may be due to the left sympathetic efferent fibers being incompletely torn or stretched because of flexion, extension, or axial rotation of the lower cervical vertebrae that occurred at the traffic accident.

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