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Anesthesiology Research and Practice
Volume 2011, Article ID 494975, 4 pages
http://dx.doi.org/10.1155/2011/494975
Case Report

Complex Regional Pain Syndrome Revived by Epileptic Seizure Then Disappeared Soon during Treatment with Regional Intravenous Nerve Blockade: A Case Report

1Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan
2Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
3Kobe Advanced ICT Research Center, National Institute of Information and Communications Technology, Kobe 651-2492, Japan

Received 20 December 2010; Accepted 3 March 2011

Academic Editor: Masahiko Kawaguchi

Copyright © 2011 Masahiko Sumitani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a case of complex regional pain syndrome (CRPS), in which symptoms, including burning pain and severe allodynia, were alleviated by using a regional intravenous nerve blockade (Bier block) combined with physiotherapy, but reappeared following an epileptic seizure. Symptoms disappeared again following control of epileptic discharges, as revealed by single-photon emission computed tomography (SPECT) and electroencephalography (EEG) results. Although systemic toxicity of a local anesthetic applied by Bier block was suspected as a cause of the first seizure, the patient did not present any other toxic symptoms, and seizures repeatedly occurred after Bier block cessation; the patient was then diagnosed as having temporal symptomatic epilepsy. This case suggests that symptoms of CRPS may be sustained by abnormal brain conditions, and our findings contribute to the understanding of how the central nervous system participates in maintaining pain and allodynia associated with CRPS.