A 37 YEAR OLD MEN WITH SOMATIC SYMPTOM DISORDER SECONDARY TO COMPLEX REGIONAL PAIN SYNDROME: REPORT OF CASE

• DOI: 10.22533/at.ed.5442215021

• Palavras-chave: SOMATIC SYMPTOM COMPLEX REGIONAL PAIN SYNDROME

• Keywords: SOMATIC SYMPTOM COMPLEX REGIONAL PAIN SYNDROME

• Abstract:

  E.D.S., 37 years old, Higher Education, hight handed, Natural from São Paulo - SP, coming from: São Gabriel da Cachoeira - AM  3 years ago, married. Patient reports that after falling from his height on December 2016, he had  a left ankle injury , referring to be sustained, intense, daily pain that improved at rest and worsened in movement. He reports progressive pain irradiation to the lumbosacral region 2 months after the onset of symptoms, and the lower left limb presented cyanotic or hyperemic, being diagnosed with Complex Regional Pain Syndrome (CRPS). During this period he was followed up with Physical Therapy. After 5 months of injury, the patient had an anal pain with the same characteristics and during the physical therapy he presented spasms in lower left limb, type of shock during the movement. He report that after 6 months of the onset of the condition, the spasms intensified and there was a change in the pattern for action tremors, myoclonus, as well as the involuntary movements were not restricted only in the lower left limb and moved to other locations such as left hand and face presenting a varied duration of 5 to 10 minutes, with no specific period to occur and often varied from 1 to 2 times a week, with no triggering factor. Nowadays, he reports that in the last 6 months, there has been an increase in the frequency of involuntary movements, presenting daily with varying duration. He also reports a weight gain of 50kg during this period. After intense investigation, the patient was diagnosed with Somatoform Disorders (SD). 

  Discursion: The CRPS is an entity that represents chronic algic involvement, in which the pathophysiology is not fully understood accompanied by vasomotor changes, pain, and usually preceded by trauma, may presents motor disorders such as tremors, dystonias or muscular weakness. Although the diagnosis is clinical, it is of exclusion, the psychiatric alterations are infrequent, when present it presents great anxiety. The SD is associated with physical symptoms suggestive of pathophysiological changes although without demonstrable organic causes or functional mechanisms known and It is observed psychic and mental dysfunctions and the symptoms extrapolate the field of intention or simulation. 

  Final comments: Both the diagnosis of CRPS and SD are not easy, it is an exclusion diagnosis and the patient must be accompanied by a multidisciplinary team.

• Número de páginas: 1