Distrofia simpático-refleja y mioclonías: una asociación infrecuente / Complex regional pain syndrome and myoclonus: an uncommon combination

RESUMEN

La distrofia simpático-refleja es una patología infrecuente en la edad pediátrica, que no se relaciona con un trastorno orgánico subyacente y que requiere un tratamiento multidisciplinar debido al importante componente psicosomático que lo acompaña y al difícil control de los síntomas en este cuadro. Por otro lado, las mioclonías tienen un amplio espectro de diagnósticos diferenciales, siendo muy importante descartar enfermedades neurológicas y degenerativas subyacentes. Presentamos el caso de un varón adolescente con dolor neuropático en una localización atípica y con una presentación compleja al asociar mioclonías y distonías a lo largo de su evolución, que obliga a la revisión de ambos cuadros y a realizar un amplio diagnóstico diferencial (AU)

ABSTRACT

Complex regional pain syndrome (CRPS) is quite uncommon in paediatric patients.There is no identified organic aetiology. CRPS has a very significant psychosomatic component; therefore it is necessary to take a multidisciplinary approach to its treatment, which should include psychiatric assessment. CRPS is very difficult to diagnose, and can take months to control its symptoms. The association with myoclonus is rare, and since myoclonus is the clinical manifestation of a vast spectrum of different neurological disorders, some of which are degenerative, it is important to make a diagnosis as quickly as possible.We present the case of an adolescent male with an atypical presentation of CRPS. CRPS was located in the thorax, which is very unusual and was associated with myoclonus and dystonias.This made the diagnosis harder and widened the aetiological spectrum (AU)