A Case of Successful Treatment of Iatrogenic Superficial Cervical Plexus Neuropathy Following Upper Extremity Surgery with Interscalene Brachial Plexus Block

Abstract

Objectives To describe the successful treatment for iatrogenic superficial cervical plexus neuropathy following brachial plexus block, which is a rare complication of this procedure. Case Report We present a case report of a 67-year-old male who underwent a surgical excision of gouty tophi of the thumb and index finger with brachial plexus block for postoperative pain control. He had no prior history of chronic headaches or facial neuropathic pain. Thirty-six hours following surgery the patient experienced burning pain in his occiput, jaw, ear, and proximal shoulder. The patient was diagnosed with iatrogenic superficial cervical plexus neuropathy, which proved refractory to oral methylprednisolone and neuropathic medications. A superficial cervical plexus injection with bupivacaine and dexamethasone resulted in an 80% resolution of pain for over 6 months. Conclusion Superficial cervical plexus injury may occur following interscalene brachial plexus nerve block. Superficial cervical plexus block may provide early effective treatment for neuropathy refractory to conservative measures.