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Brain, Vol. 119, No. 6, 2063-2072, 1996
© 1996 Guarantors of Brain

research-article

Collateral sprouting of cutaneous nerves in man

Ciaran Healy1,, Pamela M. LeQuesne1 and Bruce Lynn2

1The Reta Lila Weston Institute of Neurological Studies London, UK 2Department of Physiology, University College London Medical School London, UK

Correspondence to: Correspondence to: Ciaran Healy MD, Department of Plastic and Reconstructive Surgery, St Thomas' Hospital, Lambeth Palace Road London SE1 7EH

Cutaneous nerve collateral sprouting was studied in 20 adults in whom a forearm cutaneous nerve had been resected from the upper arm, such that any recovery of cutaneous nerve function could not be accounted for by nerve regeneration. Ten patients entered the study immediately following surgery and the remainder at intervals thereafter, permitting a longitudinal study covering a 27-month period. Modality–specific stimuli were used to study light touch, sharp pain, cooling, warming and heat pain sensation. Efferent sympathetic C fibre function was determined by measuring sweating in response to total body heating. Though the patients described considerable subjective reduction in the sensory defect within 2 months, by 10–15 months the objective sensory tests showed encroachment at the margin by only 6 mm (P < 0.05) for light touch, 7 mm (P < 0.01) for sharp pain and 11.5 mm (P < 0.001) for heat pain, with no significant change for warming or cooling. By 24 months, recovery of sweating was evident within the zone of persistent sensory loss, for 3 cm beyond the initial light touch margin (P < 0.005). This finding has important clinical implications as it calls into question the reliance placed on the recovery of sweating as evidence of nerve regeneration.

cutaneous nerve injury; sweating (recovery of); sensory recovery; collateral sprouting

Received July 4, 1996. Accepted August 5, 1996.


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