Pain Phenomena and Sensory Recovery following Brachial Plexus Avulsion Injury and Surgical Repairs
- 1 December 2006
- journal article
- Published by SAGE Publications in Journal of Hand Surgery (European Volume)
- Vol. 31 (6) , 596-605
- https://doi.org/10.1016/j.jhsb.2006.04.027
Abstract
Seventy-six patients with severe brachial plexus avulsion injuries were studied using pain questionnaires and quantitative sensory testing. There was significant correlation between pain intensity and the number of roots avulsed prior to surgery ( P = 0.0004) and surgical repairs were associated with pain relief. Sensory recovery to thermal stimuli was observed, mainly in the C5 dermatome. Allodynia to mechanical and thermal stimuli was observed in the border zone of affected and unaffected dermatomes in 18% of patients assessed early (6 months) in 12% of patients and were related to nerve regeneration. By contrast, “wrong-way” referred sensations (e.g. down the affected arm while shaving or drinking cold fluids) were reported by 44% of patients and often occurred early, suggesting CNS plasticity. Understanding sensory mechanisms will help develop new treatments for severe brachial plexus injuries.Keywords
This publication has 59 references indexed in Scilit:
- Dissecting out mechanisms responsible for peripheral neuropathic pain: Implications for diagnosis and therapyLife Sciences, 2004
- Referred Sensations Following StrokeNeurocase, 2001
- Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imagingJournal of Neurosurgery, 2000
- Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputationNature, 1995
- Phantom limb pain: are cutaneous nociceptors and spinothalamic neurons involved in the signaling and maintenance of spontaneous and touch-evoked pain? A case reportPAIN®, 1995
- Reorganization of Cortical Representations of the Hand Following Alterations of Skin Inputs Induced by Nerve Injury, Skin Island Transfers, and ExperienceJournal of Hand Therapy, 1993
- Sprouting of peripherally regenerating primary sensory neurones in the adult central nervous systemJournal of Comparative Neurology, 1991
- Expansion of spinal cord primary sensory afferent projection following combined sciatic nerve resection and saphenous nerve crush: A horseradish peroxidase study in the adult ratJournal of Comparative Neurology, 1988
- Referred itch (Mitempfindungen).BMJ, 1976
- Referred cutaneous sensationExperimental Neurology, 1973