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Table 5. Common Pain Syndromes Due to Peripheral Nerve Injury
| Pain syndrome | Associated signs and symptoms | Affected nerves |
|---|---|---|
| Tumor infiltration of a peripheral nerve | Constant, burning pain with dysesthesia in an area of sensory loss | Peripheral |
| Pain is radicular and often unilateral | ||
| Postradical neck dissection | Tight, burning sensation in the area of sensory loss | Cervical plexus |
| Dysesthesias and shocklike pain may be present | ||
| Second type of pain may occur mimicking a drooped shoulder syndrome | ||
| Postmastectomy pain | Tight, constricting, burning pain in the posterior arm, axilla, and anterior chest wall | Intercostobrachial |
| Pain exacerbated by arm movement | ||
| Postthoracotomy pain | Aching sensation in the distribution of the incision with sensory loss with or without autonomic changes | Intercostal |
| Often exquisite point tenderness at the most medial and apical points of the scar with a specific trigger point | ||
| Secondary reflex sympathetic dystrophy may develop | ||
| Postnephrectomy pain | Numbness, fullness, or heaviness in the flank, anterior abdomen, and groin | Superficial flank |
| Dysesthesias are common | ||
| Postlimb amputation | Phantom limb pain usually occurs after pain in the same site before amputation | Peripheral endings and their central projections |
| Stump pain occurs at the site of the surgical scar, several months to years after surgery. It is characterized by a burning dysesthetic sensation that is exacerbated by movement | ||
| Chemotherapy-induced peripheral neuropathy | Painful paresthesias and dysesthesias | Distal areas of peripheral (e.g., polyneuropathy) |
| Hyporeflexia | ||
| Less frequently: motor and sensory loss; rarely: autonomic dysfunction | ||
| Commonly associated with the vinca alkaloids, cisplatin, and Taxol | ||
| Radiation-induced peripheral nerve tumors | May promote malignant fibrosarcoma | Superficial and deep |
| Painful, enlarging mass in a previously irradiated area | ||
| Patients with neurofibromatosis more susceptible | ||
| Cranial neuropathies | Severe head pain with cranial nerve dysfunction | Cranial V, VII,IX, X, XI, XII are most common |
| Leptomeningeal disease | ||
| Base of skull metastasis | ||
| Acute and postherpetic neuropathy | Painful paresthesia and dysesthesia | Thoracic and cranial (VI) are most common |
| Constant burning and aching pain | ||
| Shocklike paroxysmal pain | ||
| Immunosuppression from disease or treatment is a risk factor; postherpetic neuropathy incidence increases with age |
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