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Post-Op Pain May Be Due to Immune Reaction

Posted Sep 24 2010 11:00am
Nerve inflammation, not surgeon error, may be to blame, researchers say

By Robert Preidt
Friday, September 24, 2010
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FRIDAY, Sept. 24 (HealthDay News) -- Nerve inflammation may be the cause of pain, numbness and weakness that some patients experience after surgery, according to a new study.

These problems, called postsurgical neuropathies, are typically believed to be the result of compression or stretching of nerves during surgery. But this new study suggests that, in some patients, neuropathy is the result of the immune system attacking the nerves, leading to inflammation. Immune-suppressing drugs may prove effective in such cases, said the Mayo Clinic researchers.

"It is important that a person with postsurgical inflammatory neuropathy receive a diagnosis and treatment quickly. Understanding the role of inflammation in these patients' neuropathy can lead to appropriate immunotherapy and improvement of neurological symptoms and impairments," study senior author and neurologist Dr. P. James Dyck said in a Mayo news release.

He and his colleagues studied 23 patients who developed neuropathy within 30 days of undergoing orthopedic, abdominal, chest or dental surgery. These patients were selected because their neuropathy didn't appear to be caused by compression or stretching of the nerves.

Nerve biopsies revealed increased inflammation in 21 of the patients. Seventeen of them received three months of immunotherapy, after which all showed improvements in their neuropathy symptoms.

The study was published online Sept. 20 in the journal Brain.

"It is logical for patients to believe that it was the surgeon's fault that they developed a neuropathy because it occurred after the surgery. However, in these cases, we have strong evidence that the neuropathies were not the surgeon's fault but were caused by the immune system attacking the nerves," Dyck said.

SOURCE: Mayo Clinic, news release, Sept. 22, 2010

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