We would like to thank Mrs. Mirella Ferrari who assisted our patient during her conventional rehabilitation.

induces MEPs of 50 mV peak-to-peak amplitude in the targetsmuscle in 50% of the trials [3]. The effect of the treatment was assessed by means of Neuropathy Pain Scale [4], the Visual Analogue Scale (VAS) [5], the Psychological Well-being Scale (PWB) [6], and the SF-36 [7]. After the treatment the patient reported the complete disappearance of the hyperesthesia in the shoulder and an improvement of pain sensation in the forearm, as it changed “from an electric shock-like pain to a sort of tingling”. Although an objective improvement of the symptoms has been recorded by means of Neuropathic Pain Scale (NPS), the Visual Analogue Scale (VAS) and the PWB, the SF36 didn’t show an improvement of the global health-status (Table 1). This contradictory result may be explained by the fact that the patient had a right upper limb plegia and then her health-related quality of life was surely more influenced by the motor deficit then the pain. We want to highlight that after the eighth rTMS session the patient reported a subjective vertigo so that the treatment was interrupted; the symptom lasted for several week after the interruption of the treatment. Allodynia is a common aspect of neuropathic pain which often can be a consequence of brachial plexus injury and it is often resistant to standard pharmacological therapies. To date only one study discussed the role of rTMS in the management of hyperalgesia and tactile allodynia; in this study hyperalgesia was artificially provoked and a reduction of the hyperactive area was observed by means of fMRI after a rTMS protocol applied on the posterior parietal cortex (PPC). Any clinical assessment was performed [8]. We showed for the first time the effectiveness of rTMS in a patient suffering from allodynia due to a brachial plexus injury. The clinical improvement induced by high frequency rTMS in this case was clear-cut and long-lasting; the patient reported a subjective vertigo after the eighth rTMS session but the symptom didn’t seem to be a consequence of the stimulation as it lasted for several week after the interruption of the treatment. In conclusion our results suggest that rTMS of the motor cortex should be considered early in the treatment of allodynia due to a brachial plexus injury.