In this issue of the Scandinavian Journal of Pain, Brown and co-workers publish a randomized controlled trial comparing amitriptyline and gabapentin for the treatment of complex regional pain syndrome (CRPS) type I and neuropathic pain in children . There is an urgent need for well-performed trials in paediatric pain to guide clinical practice, and this study is the first randomized trial to compare first-line drugs for these conditions in the paediatric population.1Complex regional pain syndrome (CRPS)CRPS is a condition characterized by spontaneous and evoked pain, oedema, changes in skin colour and temperature and trophic changes in the distal extremities. CRPS type I typically occurs after minor trauma without affecting the nerves, whereas type II is associated with nerve damage, but CRPS may occur irrespective of the nerve innervation territory . The diagnostic criteria for CRPS include continuing pain disproportional to any inciting event, at least three of sensory (hyperesthesia or allodynia), vasomotor, sudomotor or trophic symptoms and at least one sensory, vasomotor, sudomotor or trophic sign . The pathophysiology is complex and may include both inflammatory and central sensitization mechanisms . CRPS may also affect children and adolescents, in particular girls . CRPS has a relatively good prognosis in
Scandinavian Journal of Pain – de Gruyter
Published: Oct 1, 2016
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