Atypical reflex sympathetic dystrophy and paravertebral sympathetic block

This is the report of a young girl who developed atypical reflex sympathetic dystrophy syndrome, with decreased uptake of Technetium 99 (^99mTc) following minor trauma of the ankle joint. The patient was treated with a single lumbar paravertebral sympathetic block followed by intensive physiotherapy. Immediate significant and prolonged improvement was achieved. There was recurrence 8 months later without apparent cause, again as an atypical form of the reflex sympathetic dystrophy syndrome with decreased bone uptake of ^99mTc; the same treatment was repeated and resulted in complete recovery. Sympathetic block with local anaesthetic of the paravertebral sympathetic ganglia is an effective procedure for diagnosis and treatment of both typical and atypical forms of the reflex sympathetic dystrophy syndrome in the early stages of the disease.