Deafferentation pain following brachial plexus avulsion injuries

Abstract

Brachial plexus avulsion injuries represent one of the most severe nerve injuries resulting in debilitating sensory and motor deficits. Besides functional impairments, most affected patients suffer from a chronic pain syndrome, referred to as deafferentation pain. Its origin is thought to arise due to scar formation in the dorsal horn after traumatic nerve root avulsion. At a later stage, central mechanisms including cortical reorganization maintain the pain. Drug therapy often fails to improve pain with interest growing in behavioral treatment modalities. Most importantly, it has been shown that successful nerve reconstruction results both in functional recovery and reduction of deafferentation pain as the central nervous system regains sensory feedback from the previously denervated limb.