Management of pain after brachial plexus injury: a parallel study

Waikakul, Saranatra; Waikakul, Waraporn; Pausawasdi, S

doi:10.1163/156856903321579244

Cited by 6 publications

(9 citation statements)

References 15 publications

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“…In accordance with the findings of Narakas, we observed that patients with less intense pain have a higher rate of pain resolution. Contrary to what we observed, however, Waikakul et al (42) detected minimal pain relief in their subjects 2 weeks after surgery. What may explain this difference is the fact that they performed intercostal nerve transfers, rather than grafting of roots of the brachial plexus; 2 years after surgery, 32% of their patients were pain free com-pared with 60% of our patients.…”

Section: Bertelli and Ghizonicontrasting

confidence: 99%

“…We have combined root grafting with nerve transfers. Contrary to Waikakul et al (42) and Berman et al (9), our nerve transfers were projected to improve function in precise target nerves, for instance, the suprascapular nerve, medial pectoral nerve, and triceps long head motor branch. These nerves are not associated with any painful cutaneous territory, such as the forearm or hand.…”

Section: Bertelli and Ghizonimentioning

confidence: 79%

“…Pain relief has been associated with motor and/or sensory recovery (9,23,42). In these studies, authors compared preoperative data with data collected at the final evaluation years after surgery.…”

Section: Subacute Palsy (Brachial Plexus Repair Group)mentioning

confidence: 99%

“…This might be related to the diminished capacity for regeneration among chronically damaged neurons (19). Interestingly, Waikakul et al (42) also observed that those patients who elected not to have surgery and who started treatment with oral analgesic 4 months or more post injury were less likely to experience pain resolution than those for whom conservative treatment had been initiated earlier.…”

Section: Chronic Palsymentioning

confidence: 99%

“…C omplete brachial plexus palsy after avulsion injuries is associated with pain in almost 80% of patients (13,17,42,44). Pain usually begins within days of injury and generally persists (28,43).…”

mentioning

confidence: 99%

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Pain After Avulsion Injuries and Complete Palsy of the Brachial Plexus

Bertelli

Ghizoni

2008

Neurosurgery

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Section: Bertelli and Ghizonicontrasting

confidence: 99%

Section: Bertelli and Ghizonimentioning

confidence: 79%

Section: Subacute Palsy (Brachial Plexus Repair Group)mentioning

confidence: 99%

Section: Chronic Palsymentioning

confidence: 99%

mentioning

confidence: 99%

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Pain After Avulsion Injuries and Complete Palsy of the Brachial Plexus

Bertelli

Ghizoni

2008

Neurosurgery

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Slow Cardiac Myosin Regulatory Light Chain 2 (MYL2) was Down‐Expressed in Chronic Heart Failure Patients

Tang

et al. 2010

Clinical Cardiology

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BackgroundGenetic studies have shown that many slow cardiac myosin regulatory light chain 2 (MYL2) gene mutations can cause hypertrophic cardiomyopathy, which is one of the most common causes of heart failure (HF). But until now there has been no pathological or histological evidence that MYL2 may be associated with HF development. Recent microarray studies indicated that myosin heavy chain expression changed in the pathological process of HF. Because MYL2 is a regulatory component of myosin heavy polypeptide, the role of MYL2 protein in HF needs to be studied.HypothesisThe level of expression of MYL2 may change in the heart tissue of patients with chronic HF.MethodsWe collected 28 human right auricle samples, 16 from chronic HF patients and 12 from healthy control subjects. Immunohistochemistry was carried out to observe the tissue‐expression pattern of the MYL2 protein and Western blot methods were performed to quantify the relative MYL2 expression level.ResultsIn chronic HF patients, the MYL2 protein level decreased significantly compared with normal controls (t test P < 0.05). Among the 16 HF patients, MYL2 expression in the severe HF group (New York Heart Association [NYHA] class III or IV) was even lower than that of the moderate HF group (NYHA class II) (t test P < 0.05).ConclusionsMYL2 was down‐expressed in HF tissues, and our findings suggested that MYL2 may play a role in the development and progression of chronic HF. Copyright © 2008 Wiley Periodicals, Inc.The first two authors contributed equally to this work. This study was supported by the National Natural Science Foundation of China (30800457, 30900803) and the Natural Science Program of Hubei Province (2009CDZ013). This study has no relationship with any kind of industry. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Sensory disturbances and pain complaints after brachial plexus root injury: A prospective study involving 150 adult patients

2010

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After injury of the brachial plexus, sensory disturbance in the affected limb varies according to the extent of root involvement. The goal of this study was to match sensory assessments and pain complaints with findings on CT myelo scans and surgical observations. One hundred fifty patients with supraclavicular stretch injury of the brachial plexus were operated upon within an average of 5.4 months of trauma. Preoperatively, upper limb sensation was evaluated using Semmes-Weinstein monofilaments. Pain complaints were recorded for each patient. With lesions affecting the upper roots of the brachial plexus, hand sensation was largerly preserved. Sensory disturbances were identified over a longitudinal bundle on the lateral arm and forearm. In C8-T1 root injuries, diminished protective sensation was observed on the ulnar aspect of the hand. If the C7 root also was injured, sensation in the long finger was impaired. Eighty-four percent of our 64 patients with total palsy reported pain, versus just 47% of our 72 patients with upper type palsies. This rate dropped to 29% in the 14 patients with a lower-type palsy. C8 and T1, when injured, always were avulsed from the cord; when avulsion of these roots was the only nerve injury, pain was absent. Hand sensation was largely preserved in patients with partial injuries of the brachial plexus, particularly on the radial side. Even when T1 was the only preserved root, hand sensation was mostly spared. This indicates that overlapping of the dermatomal zones seems much more widespread than previously reported.

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Management of pain after brachial plexus injury: a parallel study

Cited by 6 publications

References 15 publications

Pain After Avulsion Injuries and Complete Palsy of the Brachial Plexus

Pain After Avulsion Injuries and Complete Palsy of the Brachial Plexus

Slow Cardiac Myosin Regulatory Light Chain 2 (MYL2) was Down‐Expressed in Chronic Heart Failure Patients

Sensory disturbances and pain complaints after brachial plexus root injury: A prospective study involving 150 adult patients

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