Ca. Pagni et S. Canavero, PAIN, MUSCLE SPASMS AND TWITCHING FINGERS FOLLOWING BRACHIAL-PLEXUS AVULSION - REPORT OF 3 CASES RELIEVED BY DORSAL-ROOT ENTRY ZONE COAGULATION, Journal of neurology, 240(8), 1993, pp. 468-470
Three patients who, following partial brachial plexus avulsion, experi
enced pain, involuntary finger twitching and muscular spasms are repor
ted. Two exhibited cutaneous trigger zones, stimulation of which exace
rbated their pain; changes in emotional tone aggravated both the pain
and the spasms. Pain would appear to be due not only to deafferentatio
n and scarring of the dorsal horn, but also to an afferent pathologica
l barrage from partially damaged dorsal roots. The pathological sensor
y barrage may activate metameric interneuronal circuits and produce in
voluntary movements. Exacerbation of both the pain and the spasms can
be explained on the basis of intrinsic properties of these ectopic pac
emakers.