C2 and C3 Pain Dermatomes in Man

Abstract

This report defines the C2 and C3 pain dermatomes by the distribution of: the hypalgesia clearing after surgical root decompression; the dysaesthesias produced by electrical root stimulation; and the hypalgesia produced by anaesthetic root block. The C2 pain dermatome, so defined, consists of an occipital parietal area 6-8 cm wide, ascending paramedially from the subocciput to the vertex. The C3 pain dermatome is a craniofacial area including the scalp around the ear, the pinna, the lateral cheek over the angle of the jaw, the submental region and the lateral and anterior aspects of the upper neck. These C2 and C3 pain dermatomes do not overlap and are smaller than the C2 and C3 tactile dermatomes described in the literature.

An evidence‐based approach to human dermatomes

“…These methods differ in which neural structure was studied-the dorsal root, mixed spinal nerve, or spinal cord segment-and whether tactile, pain, or temperature sensation were assessed. Two more reliable methods in humans include the recording of mixed spinal nerve sensory action potentials after electrical skin stimulation (Inouye and Buchthal, 1977) and mapping the area of sensory impairment after local anesthetic spinal nerve block (Poletti, 1991;Nitta et al, 1993;Wolff et al, 2001). …”

“…Another potential problem with the use of local anesthetic nerve blocks to evaluate dermatomes is that the anesthetic agent may diffuse and not remain precisely localized. Poletti (1991) investigated C2 (n ¼ 6) and C3 (n ¼ 8) pain dermatomes by local anesthetic nerve block under fluoroscopic control. Hypoalgesia and analgesia were assessed by pinprick.…”

“…The S1 dermatome extends up the posterior aspect of the thigh probably as far as the buttock and overlaps with S2 (Cole et al, 1968;Nitta et al, 1993). Finally, it is generally agreed that C1 normally has no clinically detectable cutaneous sensory distribution (Haymaker and Woodhall, 1953;Poletti, 1991;Bonica and Loeser, 2001) and that S3, S4, and S5 supply the perineum including the anus and external genitalia (Bumke and Foerster, 1936;Haymaker and Woodhall, 1953;Bonica and Loeser, 2001).…”

Nitric oxide: emerging implications for headache mechanics

“…CEH pain radiates to the occipital area, to the vertex of the head (C2 level), to the peri-oculo-frontal-auricolar-temporal area. Sometimes even the mandibular and neck region (C3 level) are involved [46]. The pain is often continuous, non-pulsating, and non-burning, with some radicular characteristics.…”

Die epifasziale Elektrostimulation des N. occipitalis bei therapierefraktärer Okzipitalisneuralgie

“…Sein Nervenstamm verläuft weiter lateral als der des N. occipitalis major. Die SchmerzDermatome C2 und C3 sind etwas kleiner als die taktilen Dermatome und überlappen einander nicht[6].Erste Berichte über die Stimulation peripherer Nerven mit Hilfe von Elektroden stammen aus den 60er Jahren[8]. Nach Erfolgen mit perkutanen Verfahren wurden anschließend Versuche mit dem Einbringen von Elektroden in die unmittelbare Umgebung des betroffenen Nerven unternommen.…”