A case of referred pain evoked by remote light touch after partial nerve injury

An unusual case of referred pain is presented in which a 63-year-old man, w ho suffered a severe injury to his right hand and arm during young adulthoo d, describes the later development of dysesthesia and shooting pain in his arm subsequent to stimulation of the ipsilateral scalp, the temporal and in frazygomatic region of the face, and the back. Referred sensations of this type are usually reported following amputation of an arm. Clinical examinat ion of the sensory and motor function of the arm and hand revealed partial damage to the radial, ulnar and median nerves as well as possible brachial plexus involvement. Interestingly, pain could be evoked by repeated light t ouches applied to the remote trigger areas suggesting the involvement of a 'wind-up'-like process. (C) 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.