PAIN, MUSCLE SPASMS AND TWITCHING FINGERS FOLLOWING BRACHIAL-PLEXUS AVULSION - REPORT OF 3 CASES RELIEVED BY DORSAL-ROOT ENTRY ZONE COAGULATION

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.