An unusual presentation of neuropathic pain following cervical spinal cord injury: a case report

Abstract

Background:We report a patient with unusual occipital neuropathic pain (at-level neuropathic pain) due to a small central cervical spinal cord injury (SCI). Case presentation: A 50-year-old man presented with severe bilateral occipital pain after falling from a height of 2 m, 2 weeks ago. The degree of pain was evaluated to be 9 out of 10 using the numeric rating scale (NRS). The nature of the pain was tingling, burning, and piercing, and hyperalgesia was present over the bilateral posterior head regions. Greater occipital nerve block with bupivacaine and dexamethasone was not effective. On axial T2cervical magnetic resonance imaging (MRI), a focal high signal change was observed in the central portion of the spinal cord at the C2 level. We deliberated that the patient's pain was due to the SCI observed on MRI, and after administration of oral medications, the NRS pain score reduced from 9 to 2. Conclusions: Neuropathic pain caused by SCI varies according to the location and degree of injury of the painrelated neural tracts; therefore, clinicians should closely observe the pain patterns and findings on imaging in patients with SCI to determine the cause of pain accurately.

<p>Effectiveness of Intravenous Immunoglobulin for Management of Neuropathic Pain: A Narrative Review</p>

“…1 Its typical characteristic is burning or electrical sensation and pain induced by non-painful stimuli, such as light touching. [1][2][3] It occurs in various neurological disorders, such as diabetic polyneuropathy, chemotherapy-induced painful neuropathy, complex regional pain syndrome (CRPS), spinal pain, trigeminal neuralgia, postherpetic neuralgia, and other painful neuropathies. [1][2][3] Neuropathic pain is frequently refractory to several treatment methods, such as oral medication (anti-inflammatory drugs, tricyclic antidepressant, and anticonvulsant drugs), physical therapy, and procedures.…”

“…[1][2][3] It occurs in various neurological disorders, such as diabetic polyneuropathy, chemotherapy-induced painful neuropathy, complex regional pain syndrome (CRPS), spinal pain, trigeminal neuralgia, postherpetic neuralgia, and other painful neuropathies. [1][2][3] Neuropathic pain is frequently refractory to several treatment methods, such as oral medication (anti-inflammatory drugs, tricyclic antidepressant, and anticonvulsant drugs), physical therapy, and procedures. [4][5][6] Chronic neuropathic pain can also greatly impair patients' quality of life and cause depression, anxiety, and sleep disturbances.…”