Phantom Sensation-Underreported Sensory Outcome Following Intercostal-to-Musculocutaneous Nerve Transfer.
Avulsion
Brachial plexopathy
Brachial plexus
Intercostal to musculocutaneous nerve transfer
Neurotization
Peripheral nerve surgery
Sensory outcome
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
02
08
2018
revised:
28
10
2018
accepted:
29
10
2018
pubmed:
12
11
2018
medline:
26
2
2019
entrez:
12
11
2018
Statut:
ppublish
Résumé
Intercostal-to-musculocutaneous nerve transfer is commonly performed in patients with brachial plexus avulsion injuries. As techniques have improved since its inception in 1963, most patients now experience some level of motor function improvement of their affected arm. While motor outcomes are well described, there is a paucity of literature describing sensory outcomes. It is thus difficult to gauge surgical success with respect to sensory function, and there is a necessity to share clear expectations with patients regarding intended or unintended postoperative sensation. In this case report, we describe an unintended sensory outcome of this procedure. Three years after the operation, our patient experiences a "phantom sensation" on his chest when he is touched on the lateral forearm in the distribution of the lateral antebrachial cutaneous nerve. This outcome can be explained with review of the anatomy before and after the operation. The persistence of this adverse outcome suggests limitations in sensory cortical neuroplasticity. It is important to be aware of potential sensory complications in intercostal-to-musculocutaneous nerve transfer. Although this complication is known, it is often overlooked and underreported. Complications such as this should be emphasized in order to set expectations for patients and guide evaluation of sensory outcomes in a future study.
Sections du résumé
BACKGROUND
BACKGROUND
Intercostal-to-musculocutaneous nerve transfer is commonly performed in patients with brachial plexus avulsion injuries. As techniques have improved since its inception in 1963, most patients now experience some level of motor function improvement of their affected arm. While motor outcomes are well described, there is a paucity of literature describing sensory outcomes. It is thus difficult to gauge surgical success with respect to sensory function, and there is a necessity to share clear expectations with patients regarding intended or unintended postoperative sensation.
CASE DESCRIPTION
METHODS
In this case report, we describe an unintended sensory outcome of this procedure. Three years after the operation, our patient experiences a "phantom sensation" on his chest when he is touched on the lateral forearm in the distribution of the lateral antebrachial cutaneous nerve. This outcome can be explained with review of the anatomy before and after the operation. The persistence of this adverse outcome suggests limitations in sensory cortical neuroplasticity.
CONCLUSIONS
CONCLUSIONS
It is important to be aware of potential sensory complications in intercostal-to-musculocutaneous nerve transfer. Although this complication is known, it is often overlooked and underreported. Complications such as this should be emphasized in order to set expectations for patients and guide evaluation of sensory outcomes in a future study.
Identifiants
pubmed: 30415052
pii: S1878-8750(18)32523-3
doi: 10.1016/j.wneu.2018.10.216
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
303-307Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.