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Neurol India. 2019 Jan-Feb;67(Supplement):S32-S37. doi: 10.4103/0028-3886.250699.

Treatment of neuropathic pain after peripheral nerve and brachial plexus traumatic injury.

Author information

1
Peripheral Nerve and Plexus Program, Department of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.

Abstract

Peripheral nerve and brachial plexus injuries typically cause severe impairment in the affected limb. The incidence of neuropathic pain is high, reaching up to 95% of cases, especially if cervical root avulsion has occurred. Neuropathic pain results from damage to the somatosensory system, and its progression towards chronicity depends upon disruptions affecting both the peripheral and central nervous system. Managing these painful conditions is complex and must be accomplished by a multidisciplinary team, starting with first-line pharmacological therapies like tricyclic antidepressants and calcium channel ligands, combined physical and occupational therapy, transcutaneous electrical stimulation and psychological support. For patients refractory to the initial measures, several neurosurgical options are available, including nerve decompression or reconstruction and ablative/modulatory procedures.

KEYWORDS:

Brachial plexus; chronic pain; dorsal root entry zone procedure; neuropathic pain

PMID:
30688230
DOI:
10.4103/0028-3886.250699
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