Journal of Hand Surgery (European Volume)

 

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Journal of Hand Surgery (European Volume), Vol. 33, No. 2, 186-191 (2008)
DOI: 10.1177/1753193408087029

Articles

Age-Dependent Development Of Chronic Neuropathic Pain, Allodynia and Sensory Recovery after Upper Limb Nerve Injury in Children

DUNCAN D ATHERTON, OMEED TAHERZADEH, DAVID ELLIOT and PRAVEEN ANAND

From the Peripheral Neuropathy Unit, Imperial College London, Hammersmith Hospital, London, UK and the St Andrew’s Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, UK

Correspondence: Professor Praveen Anand, Imperial College London, London, UK., E-mail:p.anand{at}imperial.ac.uk.

Forty-nine children with distal upper limb nerve injury were studied at a mean follow-up of 2 years 3 months. Patients who were aged 5 years or younger at the time of nerve injury (15/49) had no chronic neuropathic pain symptoms or allodynia. Patients with allodynia on quantitative sensory testing but no spontaneous pain (8/49) were all older than 5 years and those reporting spontaneous chronic neuropathic pain (5/49) were all older than 12 years at the time of injury. Previous studies of adults with similar nerve injuries report chronic hyperaesthesia in up to 40% of cases. Semmes–Weinstein monofilament testing showed a positive correlation between age at injury and abnormal sensory threshold (r = 0.60, P<0.0001). These findings indicate that young children show better sensory recovery and are less likely to develop long-term chronic neuropathic pain syndromes than adults following nerve injury.

Key Words: neuropathic pain • nerve injury • children • sensory recovery


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