Severe Pediatric Erythromelalgia: A Case Report on Multimodal Pain Management and the Role of Regional Anesthesia

Abstract

Erythromelalgia is a rare neurovascular condition characterized by episodic burning pain, erythema, and increased temperature of the extremities. This condition, particularly challenging in pediatric patients due to its rarity and the complexities of pain management, often results in significant distress and impaired quality of life. We report the case of a 14-year-old patient who presented with severe primary erythromelalgia. Despite extensive pharmacologic interventions, the patient's pain was refractory, leading to significant psychological distress and a suicide attempt. The pain was eventually managed with carbamazepine, bilateral sciatic nerve blocks, and epidural catheter placement, providing significant pain relief and allowing time to develop a sustainable long-term treatment strategy. This report highlights the severe impact of erythromelalgia in pediatric patients and the importance of a multimodal approach in its management. Regional anesthesia proved effective in managing acute pain and stabilizing the patient's condition.