Neuralgia refers to a sharp pain occurring along the course of a nerve.This code refers to the musculocutaneous nerve, a sensory and motor nerve from the brachial plexus that innervates the muscles of the upper arm. The musculocutaneous nerve is the main branch of the upper trunk of the brachial plexus. The sensory nerve innervation is to the forearm.

Neuralgia may be caused by pressure on the nerve trunks, faulty nerve nutrition, toxins, or inflammation. Neuralgia, associated with the musculocutaneous nerve, is usually involved in brachial plexus injury. Brachial plexus roots may be injured by several factors including: gunshots; cuts; compression by tumors or aneurysms; falls; or dislocations of the shoulder resulting in brachial neuritis. Carrying heavy weights supported only at the elbow crease may be a possible factor in nerve damage and neuralgia. In addition, a misplaced antecubital injection may cause injury.

Brachial plexus injuries may appear as an acute episode or occur gradually, and can affect the plexus either diffusely or in a restricted manner. Specific signs and symptoms may include: muscle atrophy; pain; weak elbow flexion; and impaired sensation along the radial border of the forearm.

Electrophysiologic studies are used to distinguish between spinal nerve root causes and musculocutaneous nerve dysfunction. Spinal taps and myelography may be performed. Other studies may include: computed tomography (CT) scan; magnetic resonance imaging (MRI); muscle-strength testing; deep tendon reflexes (DTR); and sensory testing.

Satisfactory results are usually obtained with conservative treatment. Such measures include: physical therapy; splints; anti-inflammatory and analgesic medications; and transcutaneous electrical nerve stimulation (TENS). Surgical intervention to repair a severed nerve is a possibility.

Damage to the musculocutaneous nerve alone rarely occurs. It usually involves components of the brachial plexus. Recovery may take several months and could range from return to complete function to permanent dysfunction. Alteration in activities of daily living (ADL) and employment may require counseling.

• If the Veteran is a former prisoner of war and was interned or detained for not less than 30 days, this disease shall be service connected if manifest to a degree of disability of 10% or more at any time after discharge or release from active military, naval, or air service even though there is no record of such disease during service, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309(c) Disease subject to presumptive service connection].

• If the Veteran was exposed to an herbicide agent during active military, naval, or air service, this disease shall be service-connected if the requirements of 38 CFR 3.307(a)(6) are met even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 CFR 3.309(e). Disease subject to presumptive service connection.

• This disability shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied.  38 CFR 3.309(a)

• Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected nerve.  38 CFR 4.124 Neuralgia, cranial or peripheral.

• With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves] 38 CFR 4.124a Schedule of ratings—neurological conditions and convulsive disorders