Brachioradial pruritus--a peculiar neuropathic disorder.

The case is presented of a middle-aged woman who suffered from lancinating itch on the dorsolateral aspect of the upper arm after a loco-regional injury, first on the right and later on the left side. Brachioradial pruritus (BRP) was diagnosed. Neurophysiologic examination was compatible with a neuropathy at the C5-C6 level, while a negative nerve root block supported an additional central impact. The presumed pathophysiology of BRP is discussed in terms of a neuropathic disorder. We suggest that damage from whatever cause from either the cutaneous nerves or from the more proximal sensory pathways may be the causative physiopathologic basis for this enigmatic disorder. BRP was refractory to different therapeutic approaches, except to lamotrigine. As BRP presents a therapeutic challenge, it seems important to report lamotrigine as a potential new therapy.