Reversal of phantom pain and hand-to-face remapping after brachial plexus avulsion

Jack W Tsao; Sacha B Finn; Matthew E Miller

doi:10.1002/acn3.316

Reversal of phantom pain and hand-to-face remapping after brachial plexus avulsion

Ann Clin Transl Neurol. 2016 May 11;3(6):463-4. doi: 10.1002/acn3.316. eCollection 2016 Jun.

Authors

Jack W Tsao¹, Sacha B Finn², Matthew E Miller²

Affiliations

¹ Walter Reed National Military Medical Center Bethesda Maryland; Present address: University of Tennessee Health Science Center Memphis Tennessee.
² Walter Reed National Military Medical Center Bethesda Maryland.

Abstract

Following left brachial plexus avulsion, a 20-year-old man had phantom limb pain and remapping of sensation from his paralyzed hand onto his face. Mirror therapy (15 min daily, 5 days/week) led immediately to good movement of the phantom limb with decreased pain. Within 2 weeks following nerve graft surgery, remapping of hand sensation onto the face disappeared along with resolution of phantom limb pain. Mirror therapy coupled with nerve grafting may relieve phantom limb pain due to brachial plexus avulsion and reverse hand-to-face remapping, suggesting that both peripheral and central mechanisms mediate development of phantom limb pain and cortical reorganization/neuroplasticity after brachial plexus avulsion.