Chronic Neuropathic Pain of Brachial Plexus Avulsion Mistaken for Amputation Stump Pain for 36 Years: A Case Report

Abstract

Following an amputation of the extremities, chronic neuropathic pain and discomfort, such as phantom limb pain (phantom pain), phantom sensation, and stump pain may occur. Clinical patterns of phantom pain, phantom sensation, and pump pain may overlap and these symptoms may also exist in one patient. Serious trauma to the upper limbs can result in brachial plexus avulsion (BPA). If BPA occurs at the same time as severe trauma of the upper extremity and the amputation of the upper limb is performed, chronic neuralgia caused by BPA may be mistaken for chronic amputation pain, such as phantom limb pain or stump pain. No major treatment advances in phantom pain have been made. However, unlike phantom limb pain, chronic neuropathic pain caused by BPA can be effectively treated with dorsal root entry zone lesioning (DREZ)-otomy. We report a patient who suffered for 34 years because the neuralgia caused by BPA was accompanied by an amputation of the arm, and so was thought to be amputation stump pain rather than BPA pain. The patient's chronic BPA pain improved with microsurgical DREZ-otomy.