Neuroplasticity of the superficial radial nerve, is it different from the rest? A case report

We present the case of a patient with severe neuropathic post-traumatic pain in the radial territory, with a severe partial axonal injury of the sensory branch of the radial nerve. Multiple treatments were performed, including neurectomy of the sensory branch of the radial nerve and semi-invasive treatments, without any improvement, making the patient a candidate for the implantation of a peripheral neurostimulator. Prior to implantation, a study was conducted using diagnostic anesthetic blocks and a neurophysiological assessment with electromyography and quantitative sensory testing. It showed absence of innervation of the superficial radial nerve and the lateral antebrachial cutaneous nerve, with evidence of evoked pain like hyperalgesia. This finding suggests the presence of anastomoses with other cutaneous nerves, overlap of innervation areas, and/or central sensitization.