Clinical trials on mirror visual feedback therapy for pain in avulsion lesions of the brachial plexus

two-case report

Abstract

Recently, mirror visual feedback therapy (MVFT) was reported to have a beneficial effect on complex regional pain syndrome as well as phantom limb pain, suggesting that MVFT can be applied as a cognitive treatment for several pain disorders. Traction lesions of the brachial plexus very often result in severe refractory pain associated with deafferentation; therefore, we applied MVFT to two patients with post-brachial plexus injury pain, who were not conscious of a phantom limb. In one patient who could exercise the paralyzed limb via mental imagery during MVFT, the pain ameliorated immediately. The other patient did not establish any movement representations of the affected limb, and the treatment was ineffective. Artificial visual feedback on movements of the affected limb may re-establish the original hand/arm cortical representation. Our cases support the idea that MVFT may have a potential to treat several refractory pain disorders, although further investigations are needed.