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Intractable pruritus after traumatic spinal cord injury
Deborah A Crane1, Kenneth M Jaffee, Anjana Kundu
1Department of Rehabilitation Medicine, University of Washington, 1959 NE Pacific Street, Box 356490, Seattle, WA 98195-6490, USA. dacrane@u.washington.edu
The Journal of Spinal Cord Medicine
|September 26, 2009
Summary
A young woman experienced severe, intractable pruritus (itching) on her forearm due to a cervical spinal cord injury. This neuropathic itch was resistant to numerous treatments, highlighting the need for further research.
Area of Science:
- Neurology
- Dermatology
- Pain Medicine
Background:
- Presents a case of a young woman with incomplete traumatic cervical spinal cord injury.
- Focuses on the challenge of intractable pruritus in the dorsal forearm.
Observation:
- The pruritus distribution followed the dermatomal pattern of the spinal cord injury and vertebral fusion.
- Symptoms were linked to the spinal cord injury and potential cervical root injury.
Findings:
- The patient's pruritus was refractory to a wide range of treatments, including topical agents, oral medications (gabapentin), nerve stimulation, and various blocks.
- Despite extensive treatment attempts, the neuropathic itch persisted.
Implications:
- Underscores the need for a deeper understanding of neuropathic pruritus mechanisms.
- Suggests advanced imaging for diagnosing nerve root compression in intractable pruritus cases.
- Recommends considering epidural steroid injection for radiculopathy and sympatholysis for potential autonomic nervous system involvement.
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