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Keimyung Medical Journal 2018;37(1):43-48.
Published online July 20, 2018.
Complex Regional Pain Syndrome of the Upper Limbs Caused by Facial Pain.
Kyoung Min Noh, Ki Beom Park
Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine, Daegu, Korea. parkkibum@dsmc.or.kr
Abstract
Polyacrylamide hydrogel is a widely used filler material in cosmetic procedures performed on the face and breasts. Recently, however, complications including inflammation, deformity, and pain have been reported. The present article addresses unregulated materials/products injected as dermal fillers. The authors report a case involving a 29-year-old woman who developed severe facial pain after undergoing a cosmetic procedure with injectable triamcinolone and hyaluronidase. Two months later, the pain spread to her upper and lower limbs, and abdomen, which eventually led to the the development and diagnosis of complex regional pain syndrome (CRPS) in the upper limbs. The authors hypothesize that CRPS in the upper limbs was responsible for the facial pain through sensitization of third-order neurons and the trigeminal nucleus caudalis extending to the upper cervical segments.
Key Words: Complex regional pain syndrome, Dermal filler, Facial neuralgia, Facial pain, Hyaluronic acid
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