Three cases of referred sensation in traumatic nerve injury of the hand: implications for understanding central nervous system reorganization.
OBJECTIVE
The aim of this observational study was to explore whether patients with traumatic peripheral nerve injury of the hand perceive referred sensations; sensations that are perceived to emanate from other areas of the body than the part being stimulated. Referred sensations have been reported following amputation, somatosensory deafferentation, local anaesthesia, stroke, brachial plexus avulsion injury, spinal cord injury and complex regional pain syndrome type 1.


METHODS
Ten patients with ulnar or median nerve injuries underwent sensory testing of the face, upper body and legs, involving light touch with a cotton swab. Patients were asked to describe the location of the stimulated site, the sensations emanating from it and any other sensations experienced. Three patients with referred sensations were identified and followed over a period of time.


RESULTS
Clear and reproducible referred sensations were found in 3 out of 10 patients examined.


CONCLUSIONS
Referred sensations were found in traumatic nerve injury, providing evidence of reorganization of the central nervous system after peripheral injury.
Pourrier
Salima D
SD
Department of Rehabilitation, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Nieuwstraten
Wilbert
W
Van Cranenburgh
Ben
B
Schreuders
Ton A R
TA
Stam
Henk J
HJ
Selles
Ruud W
RW
D000328:Adult; D002540:Cerebral Cortex / Q000502:physiology*; D005260:Female; D005543:Forearm Injuries / Q000503:physiopathology* / Q000601:surgery; D006225:Hand / Q000294:innervation*; D006230:Hand Injuries / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries* / Q000601:surgery; D009473:Neuronal Plasticity / Q000502:physiology; D012677:Sensation / Q000502:physiology*; D012684:Sensory Thresholds / Q000502:physiology; D012867:Skin / Q000294:innervation; D014459:Ulnar Nerve / Q000293:injuries* / Q000601:surgery; D055815:Young Adult