Brachial Plexopathy: Next Step When Antiepileptic Drugs or Antidepressants Have Not Provided Significant Neuropathic Pain Relief

This protocol addresses brachial plexopathy with persistent neuropathic pain that has not responded adequately to first-line medical management. It defines the escalation pathway once the prior treatment line has failed its primary goal.

Previous treatment — failure condition

Antiepileptic drugs (gabapentin and carbamazepine) or antidepressants such as amitriptyline were trialled for neuropathic pain. Escalation to this protocol is indicated when that treatment line failed to achieve significant relief of neuropathic pain.

Next-line approach

For pain that remains refractory after medical therapy, a targeted surgical procedure directed at the pain pathway may be considered. Complete patient selection criteria, procedural context, and clinical decision guidance are contained in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

Nashold in 1984 described the Dorsal Root Entry Zone (DREZ) operation for rather persistent pain.

DOI: 10.1155/2014/314137

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