The clinical characteristics of neuropathic pain in patients with total brachial plexus avulsion: A 30-case study.
Neuropathic pain in patients with total brachial plexus avulsion has always been a sophisticated problem in clinical practice.


OBJECTIVE
For further researches on objective diagnosis, alleviation or even cure of neuropathic pain, we need to conclude the basic clinical features including pain intensity, distribution, type and possible risk factors.


METHODS
Thirty cases of patients with total brachial plexus avulsion were included and their baseline information was collected. Pain was evaluated by Present Pain Index using a visual analog scale; Douleur Neuropathique 4 was used for screening neuropathic pain. For more detailed pain description, the Neuropathic Pain Symptoms Inventory questionnaire and a picture showing the exact pain district were both fulfilled by all the eligible participants. The relationship between neuropathic pain and basic information, injury conditions, accompanied conditions and quality of life was tested.


RESULTS
All the participants were male in both groups. The neuropathic pain group contained 22 patients (73.33%) with the mean age of 30.18±9.47; while 29.00±7.95 in the other group. Patients with neuropathic pain presented variously in pain degree, location, type and time phase, according to the results of the Neuropathic Pain Symptoms Inventory questionnaire. Nevertheless, most pain distributed on the region of hand. Among several related factors, alcohol abuse may be possible risk factors of neuropathic pain (p=0.03). Quality of life was significantly affected by pain (p<0.01).


CONCLUSIONS
Neuropathic pain in patients with total brachial avulsion was characterized with heterogeneity in pain distribution, intensity, type and also time phase. Bad life habits might be risk factors associated with neuropathic pain. Neuropathic pain might affect quality of life of the patients with total brachial plexus avulsion remarkably.
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, 200032, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, 200032, China.
Yingjie
Y
Zhou
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, 20040, China.
Peixi
P
Liu
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, 200032, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, 200032, China.
Jing
J
Rui
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, 200032, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, 200032, China.
Xin
X
Zhao
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, 200032, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, 200032, China. Electronic address: laojie633@sina.com.
Jie
J
Lao
D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D002681:China / Q000453:epidemiology; D004185:Disability Evaluation; D006801:Humans; D008297:Male; D009437:Neuralgia / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement; D011788:Quality of Life; D064232:Visual Analog Scale
Clinical characteristics; Neuropathic pain; Neuropathic pain symptom inventory; Total brachial plexus avulsion