Diagnosis of complex regional pain syndrome type 1 in patients with corticobasal degeneration: a case report

We report a rare case of a patient with corticobasal degeneration (CBD) who was also diagnosed with complex regional pain syndrome type I (CRPS I), which has similar clinical characteristics. A 76-year-old man who had been diagnosed with CBD several years prior presented with asymmetric severe pain, postural instability, limb rigidity, limb dystonia, tremor, ideomotor apraxia, and bradykinesia especially on his left upper extremity on admission at our rehabilitation center. Additional physical examination showed darkened skin color change, edema, reduced skin elasticity, cold skin temperature, wet skin, and limited range of motion (ROM) of the left side compared to the right side. A three-phase bone scan was done resulting CRPS I. Therefore, we initiated treatment for CRPS I, including steroid pulse therapies and non-steroidal anti-inflammatory drugs (NSAID); subsequently, his left extremity pain reduced from a visual analogue scale (VAS) score of 8-9 to 3 and his functional level also improved. To the best of our knowledge, this is the first case report of a CBD patient being also diagnosed with CRPS I. Due to the similar clinical characteristics that two diseases share, we would like to inform the physicians the importance of differentiating the CRPS I from CBD for the quick proper management.