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Q: RSD

Do children get RSD?

Dr. Keti:


Reflex sympathetic dystrophy syndrome is a clinical diagnosis. This means that the doctor makes the diagnosis based on thorough history and physical examination. When seeing a new physician, it is a good idea to have a brief medical history with dates of various treatments and the response to them. Also include a brief summary of any hospitalizations and operations. It is helpful for the doctor to have a copy of this information before your appointment. Given the complexity of RSD/CRPS, it is helpful for the patient to keep their own set of relevant medical records. I have found many good links regarding RSD. You can get lots of information when you visit them. Also I have found some recent clinical trials that may be of interest to you too. Please check them for more information.

Recent Studies and Clinical Trials for RSD

New York Medical College was coordinating the study of a potentially new therapy for the treatment of Reflex Sympathetic Dystrophy Syndrome (RSDS). The drug being studied, phenoxybenzamine (Dibenzyline), is a well known drug, but has not been previously studied for treatment of RSDS by the intravenous regional route. The study will compare lidocaine alone (a standard treatment) with lidocaine plus phenoxybenzamine. Although the study will be randomized treatment, all patients will have the opportunity to receive the new treatment, either as the initial treatment, or as a second alternate treatment. The study is open to individuals 14 years of age and older with RSDS of an upper or lower extremity. This trial is being conducted at 4 centers in the United States:
1) Westchester Medical Center, Vahalla, NY, Principal Investigator is Grigory Kizelshteyn, M.D. (914) 289-1507,
2) Metropolitan Hospital Center, New York, New York, Principal Investigator is Chang Choi, M.D (212) 423-6802,
3) Cleveland Clinic Foundation in Cleveland, Ohio, Contact is Michael Beven (216) 444-4207, and
4) Fawcett Memorial Hospital in Port Charlotte, Florida, Principal Investigator is Dr. Malik (941) 627-9095.

Muscle Dystrophy Studies

The University of Medicine and Dentistry New Jersey Medical School Pain Management Center was seeking persons with Reflex Sympathetic Dystrophy Syndrome for a 7-week study that will evaluate the effectiveness of an investigational drug for relief of muscle dystonia (muscle spasm). The study involves: 3 visits to the Pain Management Center, a physical examination, Intramuscular injections at 1 of the three visits, and 8 sessions of range of motion physical therapy with the physical therapist of your choice. If you're interested in participating in this study, contact Dr. Nancy Just at (973) 972-2081.

Rehabilitative Care of Children with Neuropathic Pain
The Pain Treatment Service at Children's Hospital in Boston is conducting research of pediatric patients with Reflex Sympathetic Dystrophy Syndrome (RSDS). In a randomized prospective trial, 'we will compare the effectiveness and efficiency of two physical therapy regimens {once per week vs. three times per week.} For patients with persistent disability and pain refractory to our rehabilitative approach, we conduct clinical trials utilizing sympathetic blockade.' Other trials are:
1) Controlled Inpatient Trial of Sympathetic Blockade, and
2) Crossover Trial of nortripyline verus gabapentin for neuropathic pain. For more information, contact (617) 355-7040.

More Links and References:

    RSD Association Of America
    Clinical Practice Guidelines
    The Pain Institute in Chicago:Results Of Treatment For Patients With RSD
    Very informative abstract
    New Theory of RSD;
    About Oxycontin
    An RSD group for Patients in Chronic Pain
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