Neuropathic itch caused by nerve root compression: brachioradial pruritus and notalgia paresthetica

68 Abstract Neuropathic itch (itching or pruritus) arises from a pathology located at any point along the afferent pathway of the nervous system. It may be related to damage to the peripheral nervous system, such as in postherpetic neuropathy, brachioradial pruritus or notalgia paresthetica. It has many clinical features similar to neuropathic pain. Patients complain of itching, which is associated with burning sensation, aching, and stinging. Brachioradial pruritis (BP) is an intense itching sensation of the arm, usually between the shoulder and elbow of one or both arms. It is an enigmatic condition with a controversial etiology; some authors consider BP to be a photodermatosis, whereas other authors attribute BP to compression of cervical nerve roots. Notalgia paresthetica is an isolated mononeuropathy involving the skin over or near the scapula. Patients have a pruritus on the mid-upper back. The treatment is usually difficult, but capsaicin and local analgesic agents are the options of choice. Brachioradial pruritus and notalgia paresthetica are often unrecognized neurocutaneous conditions and therefore, a thorough history and physical examination are of utmost importance to distinguish symptoms and apply accurate therapeutic options. Neuropathic itch caused by nerve root compression: brachioradial pruritus and notalgia paresthetica