**6. Conclusions**

Brachial plexus injuries can be the source of chronic pain. This pain can be neuropathic, CRPS and/or phantom limb, particularly if there is extensive nerve root avulsion or an upper limb amputation. The pain is oftentimes excruciating and leads to a bad quality of life even interfering with the physiotherapy needed to achieve a good recovery. The response to treatment of this pain is not always as successful as expected. Some patients respond to medication, but many need neuromodulation or ablative procedures. The most effective surgical technique is the DREZ-otomy, but 10% of patients develop side effects. If the ablative procedures fail, cervical spinal cord stimulation can be attempted.

[5] Santana MVB, Bina MT, Paz MG, et al. High prevalence of neuropathic pain in the hand of patients with traumatic brachial plexus injury: A cross-sectional study. Arquivos de

Treatment of Neuropathic Pain in Brachial Plexus Injuries

http://dx.doi.org/10.5772/intechopen.82084

111

[6] Subedi A, Chaudakshetrin P, Chotisukarat H, Mandee S. Effect of co-morbid conditions on persistent neuropathic pain after brachial plexus injury in adult patients. Journal of Clinical Neurology (Seoul, Korea). 2016;**12**(4):489-494. DOI: 10.3988/jcn.2016.12.4.489 [7] Teixeira MJ, da Paz MG da S, Bina MT, et al. Neuropathic pain after brachial plexus avulsion—Central and peripheral mechanisms. BMC Neurology. 2015;**15**:73. DOI: 10.1186/

[8] Dengler NF, Antoniadis G, Grolik B, Wirtz CR, König R, Pedro MT.Mechanisms, treatment, and patient outcome of iatrogenic injury to the brachial plexus—A retrospective singlecenter study. World Neurosurgery. 2017;**107**:868-876. DOI: 10.1016/j.wneu.2017.08.119 [9] Carofino BC, Brogan DM, Kircher MF, et al. Iatrogenic nerve injuries during shoulder surgery. The Journal of Bone and Joint Surgery. American Volume. 2013;**95**(18):1667-1674.

[10] Desai KR, Nemcek AA. Iatrogenic brachial plexopathy due to improper positioning during radiofrequency ablation. Seminars in Interventional Radiology. 2011;**28**(2):167-170.

[11] Guedes-Corrêa JF, Pereira MR da C, Torrão-Junior FJL, Martins JV, Barbosa DAN. A neglected cause of iatrogenic brachial plexus injuries in psychiatric patients. Neurosurgery.

[12] Joiner ERA, Skaggs DL, Arkader A, et al. Iatrogenic nerve injuries in the treatment of supracondylar humerus fractures: Are we really just missing nerve injuries on preoperative examination? Journal of Pediatric Orthopedics. 2014;**34**(4):388-392. DOI: 10.1097/

[13] Po BT, Hansen HR. Iatrogenic brachial plexus injury: survey of the literature and of

[14] Scully WF, Wilson DJ, Parada SA, Arrington ED. Iatrogenic nerve injuries in shoulder surgery. The Journal of the American Academy of Orthopaedic Surgeons. 2013;**21**(12):

[15] Rasulić L, Savić A, Vitošević F, et al. Iatrogenic peripheral nerve injuries-surgical treatment and outcome: 10 Years' experience. World Neurosurgery. 2017;**103**:841-851.e6.

[16] Antoniadis G, Kretschmer T, Pedro MT, König RW, Heinen CPG, Richter H-P. Iatrogenic nerve injuries: Prevalence, diagnosis and treatment. Deutsches Ärzteblatt International.

[17] Zhou Y, Liu P, Rui J, Zhao X, Lao J. The clinical characteristics of neuropathic pain in patients with total brachial plexus avulsion: A 30-case study. Injury. 2016;**47**(8):

Neuro-Psiquiatria. 2016;**74**(11):895-901. DOI: 10.1590/0004-282X20160149

s12883-015-0329-x

DOI: 10.2106/JBJS.L.00238

DOI: 10.1055/s-0031-1280657

BPO.0000000000000171

717-726. DOI: 10.5435/JAAOS-21-12-717

2014;**111**(16):273-279. DOI: 10.3238/arztebl.2014.0273

1719-1724. DOI: 10.1016/j.injury.2016.05.022

DOI: 10.1016/j.wneu.2017.04.099

1 Mar 2018;**82**(3):307-311. DOI: 10.1093/neuros/nyx162

pertinent cases. Anesthesia and Analgesia. 1969;**48**(6):915-922
