22. Traumatic Plexus Lesion

Authors

  • Robert van Dongen MD, PhD, FIPP,

    1. Department of Anesthesiology Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • Steven P. Cohen MD,

    1. Pain Management Division, Department of Anesthesiology & Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, and Walter Reed Army Medical Center, Washington, District of Columbia, U.S.A.
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  • Maarten van Kleef MD, PhD, FIPP,

    1. Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, The Netherlands
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  • Nagy Mekhail MD, PhD, FIPP,

    1. Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.
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  • Frank Huygen MD, PhD, FIPP

    1. Department of Anesthesiology and Pain Management, Erasmus Medical Centre, Rotterdam, The Netherlands
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Address correspondence and reprint requests to: Robert van Dongen, MD, PhD, FIPP, UMC St Radboud, Huispost 550 Anesthesiologie/Palliatieve Zorg, Postbus 9101, 6500 HB Nijmegen, The Netherlands. E-mail: maarten.van.kleef@mumc.nl.

Abstract

Abstract:  Pain, motor, and sensory deficits characterize patients with a traumatic lesion of the brachial plexus. Frequently, more severe injuries co-exist that require immediate surgical attention.

Early rehabilitation and physical therapy are the cornerstones of treatment. Pharmacological management can be difficult. Surgical reconstruction is frequently advised when nerves are disrupted. The results, mostly from small historical reports, vary greatly. Neurostimulation may have an additional beneficial effect, especially if the pathophysiology of nociception and neuropathic pain becomes evident in these complex patients.

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