Peripheral Nerve Stimulation for Chronic Intractable Neuropathic Pain Following a Brachial Plexus Avulsion Injury: A Case Report.

IF 0.5 A&A Practice Pub Date : 2023-05-01 DOI:10.1213/XAA.0000000000001681
Quinn Tate, Robert Pagan-Rosado, Alejandro Hallo-Carrasco, Mark Friedrich B Hurdle
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Abstract

Brachial plexus avulsion injuries result in permanent motor and sensory deficits, leading to debilitating symptoms. We report the case of a 25-year-old man with chronic pain following right-sided C5-T1 nerve root avulsion without evidence of peripheral nerve injury. His pain was recalcitrant to medical and neurosurgical interventions. However, he experienced substantial (>70%) pain relief with peripheral nerve stimulation targeting the median nerve. These results agree with data suggesting collateral sprouting of sensory nerves occurs following a brachial plexus injury. Further study is needed if we are to understand the mechanisms of the peripheral nerve stimulator as a treatment option.

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外周神经刺激治疗臂丛撕脱伤后慢性难治性神经性疼痛1例。
臂丛撕脱伤导致永久性运动和感觉缺陷,导致衰弱症状。我们报告的情况下,25岁的男子慢性疼痛后右侧C5-T1神经根撕脱无周围神经损伤的证据。他的疼痛对药物和神经外科治疗无效。然而,通过外周神经刺激正中神经,患者的疼痛明显缓解(>70%)。这些结果与提示感觉神经侧支发芽发生在臂丛损伤后的数据一致。如果我们要了解周围神经刺激器作为一种治疗选择的机制,还需要进一步的研究。
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A&A Practice
A&A Practice ANESTHESIOLOGY-
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期刊介绍: A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.
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