A Typical Cause for Neuropathic Pain in a Person with a Chronic Traumatic Spinal Cord Injury

Abstract

Context: A 44-year old man with a history of a chronic T12 AIS C spinal cord injury (SCI) presented with a six month history of left chest wall neuropathic pain and upper extremity paresthesias. Findings: Assessment demonstrated a mixed picture of upper extremity and chest wall paresthesias associated with severe neuropathic pain well above the level of his original injury. MRI of cervical spine and thorax revealed the presence of cervical canal stenosis and a soft tissue tumor at the level of the ninth left intercostal space. Surgical resection of the tumor revealed an encapsulating nerve sheath tumor diagnosed by pathology as a rare peripheral benign schwannoma or neurilemoma. Conclusion: This unreported cause of neuropathic pain in a person with a chronic spinal cord injury is discussed within the context of the importance of thorough history and physical exam when evaluating individuals with previous spinal cord injury presenting with new neuropathic pain.