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Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization

Neuropathic pain following brachial plexus injury is a severe sequela that is difficult to treat. Pulsed radiofrequency (PRF) has been proved to reduce neuropathic pain after nerve injury, even though the underlying mechanism remains unclear. This case report describes the use of ultrasound-guided P...

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Autores principales: Magistroni, Ernesta, Ciclamini, Davide, Panero, Bernardino, Verna, Valter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261624/
https://www.ncbi.nlm.nih.gov/pubmed/25525439
http://dx.doi.org/10.1155/2014/429618
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author Magistroni, Ernesta
Ciclamini, Davide
Panero, Bernardino
Verna, Valter
author_facet Magistroni, Ernesta
Ciclamini, Davide
Panero, Bernardino
Verna, Valter
author_sort Magistroni, Ernesta
collection PubMed
description Neuropathic pain following brachial plexus injury is a severe sequela that is difficult to treat. Pulsed radiofrequency (PRF) has been proved to reduce neuropathic pain after nerve injury, even though the underlying mechanism remains unclear. This case report describes the use of ultrasound-guided PRF to reduce neuropathic pain in a double-level upper extremity nerve injury. A 25-year-old man who sustained a complete left brachial plexus injury with cervical root avulsion came to our attention. Since 2007 the patient has suffered from neuropathic pain (NP) involving the ulnar side of the forearm, the proximal third of the forearm, and the thumb. No pain relief was obtained by means of surgery, rehabilitation, and medications. Ultrasound-guided PRF was performed on the ulnar nerve at the elbow level. The median nerve received a PRF treatment at wrist level. After the treatment, the patient reported a consistent reduction of pain in his hand. We measured a 70% reduction of pain on the VAS scale. PRF treatment allowed our patient to return to work after a period of absence enforced by severe pain. This case showed that PRF is a useful tool when pharmacological therapy is inadequate for pain control in posttraumatic neuropathic pain.
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spelling pubmed-42616242014-12-18 Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization Magistroni, Ernesta Ciclamini, Davide Panero, Bernardino Verna, Valter Case Rep Med Case Report Neuropathic pain following brachial plexus injury is a severe sequela that is difficult to treat. Pulsed radiofrequency (PRF) has been proved to reduce neuropathic pain after nerve injury, even though the underlying mechanism remains unclear. This case report describes the use of ultrasound-guided PRF to reduce neuropathic pain in a double-level upper extremity nerve injury. A 25-year-old man who sustained a complete left brachial plexus injury with cervical root avulsion came to our attention. Since 2007 the patient has suffered from neuropathic pain (NP) involving the ulnar side of the forearm, the proximal third of the forearm, and the thumb. No pain relief was obtained by means of surgery, rehabilitation, and medications. Ultrasound-guided PRF was performed on the ulnar nerve at the elbow level. The median nerve received a PRF treatment at wrist level. After the treatment, the patient reported a consistent reduction of pain in his hand. We measured a 70% reduction of pain on the VAS scale. PRF treatment allowed our patient to return to work after a period of absence enforced by severe pain. This case showed that PRF is a useful tool when pharmacological therapy is inadequate for pain control in posttraumatic neuropathic pain. Hindawi Publishing Corporation 2014 2014-11-26 /pmc/articles/PMC4261624/ /pubmed/25525439 http://dx.doi.org/10.1155/2014/429618 Text en Copyright © 2014 Ernesta Magistroni et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Magistroni, Ernesta
Ciclamini, Davide
Panero, Bernardino
Verna, Valter
Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization
title Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization
title_full Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization
title_fullStr Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization
title_full_unstemmed Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization
title_short Ultrasound-Guided Pulse-Dose Radiofrequency: Treatment of Neuropathic Pain after Brachial Plexus Lesion and Arm Revascularization
title_sort ultrasound-guided pulse-dose radiofrequency: treatment of neuropathic pain after brachial plexus lesion and arm revascularization
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261624/
https://www.ncbi.nlm.nih.gov/pubmed/25525439
http://dx.doi.org/10.1155/2014/429618
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