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Neuropathic pain after C7 spinal nerve transection in man
Zahid Ali1, Richard A Meyer, Allan J Belzberg
1Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21218, USA.
Pain
|April 5, 2002
Summary
Surgical division of a single spinal nerve in humans can cause neuropathic pain. This case study details a patient who developed neuropathic pain, including C7 dermatome sensory changes, after a C7 nerve transfer.
Area of Science:
- Neurology
- Pain Medicine
- Neurosurgery
Background:
- Animal models are common for studying neuropathic pain.
- Neuropathic pain can arise from nerve damage or lesions.
Purpose of the Study:
- To describe a human case of neuropathic pain following surgical spinal nerve division.
- To investigate the sensory characteristics and persistence of pain after C7 nerve section.
Main Methods:
- Case study of a patient undergoing C7 nerve transfer for brachial plexus injury.
- Extensive sensory testing (mechanical, thermal) in the C7 dermatome.
- Pharmacological assessment using phentolamine infusion for sympathetic blockade.
Main Results:
- One patient developed transient neuropathic pain, dysesthesia, and hyperalgesia in the C7 dermatome.
- Pain and hyperalgesia were present despite sympathetic blockade.
- Sensory abnormalities resolved to mild paresthesia at one year.
Conclusions:
- Surgical division of a single human spinal nerve can induce a neuropathic pain syndrome.
- The findings provide a human correlate to animal models of nerve injury-induced pain.
- This case highlights a potential complication of nerve transfer procedures.