Traumatic peripheral nerve injuries: epidemiological findings, neuropathic pain and quality of life in 158 patients

Abstract

The objectives of this study were (1) epidemiological analysis of traumatic peripheral nerve injuries; (2) assessment of neuropathic pain and quality of life in patients affected by traumatic neuropathies. All consecutive patients with a diagnosis of traumatic neuropathies from four Italian centres were enrolled. Electromyography confirmed clinical level and site diagnosis of peripheral nerve injury. All patients were evaluated by disability scales, pain screening tools, and quality of life tests. 158 consecutive patients for a total of 211 traumatic neuropathies were analysed. The brachial plexus was a frequent site of traumatic injury (36%) and the radial, ulnar, and peroneal were the most commonly involved nerves with 15% of iatrogenic injuries. Seventy-two percent of the traumatic neuropathies were painful. Pain was present in 66% and neuropathic pain in 50% of all patients. Patients had worse quality of life scores than did the healthy Italian population. Moreover, there was a strong correlation between the quality of life and the severity of the pain, particularly neuropathic pain (Short Form-36 [SF-36] p < 0.005; Beck Depression Inventory [BDI] p < 0.0001). Traumatic neuropathies were more frequent in young males after road accidents, mainly in the upper limbs. Severe neuropathic pain and not only disability contributed to worsening the quality of life in patients with traumatic neuropathies.

Expression of activating transcription factor 3 (ATF3) in uninjured dorsal root ganglion neurons in a lower trunk avulsion pain model in rats

“…Ciaramitaro [15] reported that the incidence of neuropathic pain in peripheral nerve injury was 52 % and following root avulsion injury was 100 %.…”

“…The plantar surface of the rat forepaw is innervated by the C6-C8 spinal nerves and the rat hindpaw is innervated by the L3-L5 spinal nerves [10]. Regarding cervical nerve injury, C7/8 dorsal rhizotomy [19], C7 spinal nerve compression [20], spinal nerve ligation [20], and BPA [15] are all capable of contributing to neuropathic plantar pain in the rat. In these studies, injury-level DRG neurons were evaluated and were activated by nerve injury, but uninjuredlevel DRG neurons were not evaluated.…”

Falls and peripheral nerve injuries: an age-dependent relationship

“…PNIs are associated with considerable economic burden for society, since they frequently result in multiple restorative operations, extensive rehabilitation, and long-term disability. 5,8,16,[19][20][21] Depending on the type of injury, several operative approaches are undertaken that range from simple decompression to nerve grafting.…”

“…PNIs do not contribute to immediate mortality, but they can significantly impact the long-term quality of life of the affected individuals. 5 PNIs result in major social and economic burden. Functional disability associated with nerve injuries can be devastating.…”

“…Functional disability associated with nerve injuries can be devastating. 5 Their repair frequently requires complicated operations, with variable functional improvement. 8 Despite their negative impact on long-term population health, the prevalence of PNIs in fall-injured patients and the factors associated with their occurrence in this group are largely unknown.…”