From the Department of Physical Medicine and Rehabilitation, Penn Medicine, Philadelphia, Pennsylvania.
Department of Pain Medicine, Mayo Clinic, Jacksonville, Florida.
A A Pract. 2023 May 5;17(5):e01681. doi: 10.1213/XAA.0000000000001681. eCollection 2023 May 1.
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.
臂丛撕脱伤导致永久性运动和感觉功能障碍,引起使人虚弱的症状。我们报告了一例右侧 C5-T1 神经根撕脱后慢性疼痛的 25 岁男性病例,无周围神经损伤证据。他的疼痛对药物和神经外科干预均无反应。但是,通过刺激正中神经的外周神经刺激,他的疼痛得到了显著缓解(>70%)。这些结果与臂丛损伤后感觉神经发生侧支发芽的数据一致。如果我们要了解外周神经刺激器作为治疗选择的机制,还需要进一步研究。