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Somato-somatic referred pain caused by suprasegmental spinal cord tumor

Departments of Neurology (Drs. Lee and Phillips) and Neurosurgery (Dr. Jane), University of Virginia Health Sciences Center, Charlottesville, VA.

Tactile stimulation of a coin-sized area in a T-2 dermatome consistently triggered a lancinating pain in the ipsilateral C-8 dermatome in a 38-year-old woman. The SEP and an MRI led to a diagnosis of a tumor at the left cervico-medullary junction, much higher than the clinically suspected level. Surgical exploration revealed an exophytic glioma, and the pain was abolished postoperatively. Ephaptic transmission at the tumor site was suspected as a pathophysiologic mechanism.

Address correspondence and reprint requests to Dr. Soo Ik Lee, Department of Neurology, Box 394, University of Virginia Health Sciences Center, Charlottesville, VA 22908.

Presented in part at the Joint Meeting of the American Electroencephalographic Society and the American Association of Electromyography and Electrodiagnosis, San Diego, 1988.

Received July 9, 1990. Accepted for publication in final form November 13, 1990.