Treatment of CRPS with ECT.

BACKGROUND Electroconvulsive therapy (ECT) is a well-established treatment method for medically refractory depression. ECT has also been used in the treatment of pain for over 50 years. The mechanism of action of ECT is still unknown, although several observations have been made regarding the effect of ECT on pain processes. It has been reported that several patients with medically refractory depression and Complex Regional Pain Syndrome who were treated with ECT for their depression were also cured of their CRPS symptoms. OBJECTIVE We report a case of CRPS in a patient who also suffered from medically refractory depression. She was treated with ECT for her depression and subsequently was relieved of all her CRPS symptoms. CASE REPORT A 42 year-old female patient underwent a series of 12 standard bitemporal electroconvulsive therapy treatments for medically refractory depression. Physical examination and Quantitative Sensory Testing was done before and after the patient's treatment with ECT. This standard treatment procedure for refractory depression completely resolved the patient's depressive symptoms. In addition, the patient's CRPS symptoms were also reversed. Physical examination as well as Quantitative Sensory Testing done before and after the ECT treatment correlated with her CRPS symptom improvement. CONCLUSION ECT was effective in the treatment of severe refractory CRPS in this patient.