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Brachial plexus traction injury: quantification of sensory abnormalities
Robert J Schwartzman1, John R Grothusen
1Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania 19102-1192, USA.
Pain Medicine (Malden, Mass.)
|October 28, 2008
Summary
Brachial plexus traction injuries, often from car accidents, can be diagnosed by quantifying sensory abnormalities. This study found decreased pain thresholds and increased sensory detection thresholds in patients, suggesting small fiber dysfunction and neuropathic pain.
Area of Science:
- Neurology
- Orthopedics
- Pain Medicine
Background:
- Brachial plexus stretch injuries commonly result from cervical spine trauma.
- Conventional diagnostic methods like imaging and nerve conduction studies are often inconclusive for these injuries.
- Clinical examination reveals sensory abnormalities, but quantification is needed for diagnosis.
Purpose of the Study:
- To simplify, standardize, and quantify sensory abnormalities in brachial plexus traction injuries.
- To differentiate between positive and negative sensory findings.
- To provide objective measures for diagnosing brachial plexus traction injuries.
Main Methods:
- Quantified sensory detection and pain thresholds (thermal, vibration, pressure) in 38 patients with brachial plexus traction injury.
- Included the elevated arm stress test.
- Compared patient data with age- and sex-matched control subjects.
Main Results:
- Patients exhibited significantly decreased evoked pain thresholds (excluding heat pain).
- Sensory detection thresholds were significantly increased in patients compared to controls.
- These findings indicate distinct sensory deficits in brachial plexus traction injury.
Conclusions:
- Quantification of sensory findings aids in diagnosing brachial plexus traction injuries.
- The results support the hypothesis of small sensory fiber system dysfunction.
- Brachial plexus traction injury is associated with a form of neuropathic pain.
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