Acute paralytic brachial neuritis

Weikers, Norbert J.; Mattson, Richard H.

doi:10.1212/wnl.19.12.1153

Cited by 80 publications

(38 citation statements)

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“…Although not present initially, weakness may develop a few days to weeks after the initial onset of symptoms. Sensory deficits are known to occur but vary in prevalence with one study reporting deficits in 66% of patients [15] while another found them in a minority of patients [88]. The sudden loss of strength may not be recognized immediately because of the patient's reluctance to utilize the affected area due to the debilitating nature of the pain.…”

Section: Introductionmentioning

confidence: 99%

Parsonage-Turner Syndrome

Feinberg

Radecki

2010

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

154

171

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Parsonage-Turner Syndrome (PTS), also referred to as idiopathic brachial plexopathy or neuralgic amyotrophy, is a rare disorder consisting of a complex constellation of symptoms with abrupt onset of shoulder pain, usually unilaterally, followed by progressive neurologic deficits of motor weakness, dysesthesias, and numbness. Although the etiology of the syndrome is unclear, it is reported in various clinical situations, including postoperatively, postinfectious, posttraumatic, and postvaccination. The identification of the syndrome in the postoperative patient remains a challenge as symptoms may easily be attributed to sequelae of surgical positioning, postoperative recovery, or postanesthetic block pain. The purpose of this review is to bring forth salient, identifiable factors which may assist the surgical clinician in identifying the condition sooner. An early and proper diagnosis affords the opportunity to treat the patient accordingly and to the satisfaction of both surgeon and patient.

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Section: Introductionmentioning

confidence: 99%

Parsonage-Turner Syndrome

Feinberg

Radecki

2010

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

154

171

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“…In a 2nd report on patients with IBP, 4 had no median or ulnar SNAP in the affected arm [ 10]. However, those patients had wide spread abnormalities on N CS, suggesting a more diffuse peripheral neuropathy and thus calling into question the anatomically limited diagnosis of BP.…”

Section: Discussionmentioning

confidence: 97%

Sensory Nerve Abnormalities in Brachial Plexopathy

Rubin

Lange

1992

Eur Neurol

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Sensory nerve action potential (SNAP) amplitude should be abnormal in brachial plexopathies (BP) which cause axonal degeneration in distal segments. Fifty-six patients with BP were identified. In diffuse BP, 22/25 (88%) showed low amplitude or absent median or ulnar SNAP. Three of 5 patients with upper trunk BP had low amplitude or absent SNAP (1 median, 1 radial, 1 lateral antebrachial cutaneous). Seventy-five percent of patients with lower trunk/medial cord BP had low amplitude or absent SNAP (8/24 median, 18/24 ulnar). Overall, 82.5% of patients had low amplitude or absent SNAP when a sensory nerve in the distribution of signs was studied. Testing multiple sensory nerves to include symptomatic regions enhances the diagnostic yield of SNAP in BP.

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“…There is full motor recovery in approximately 36% of patients at 1 year, 75% of patients at 2 years, and in 89% of patients at 3 years [38]. Sensory changes are often not a significant complaint or finding [43] but sensory deficits were observed in 66% of patients in one study [6] and in a minority of patients in another [43].…”

Section: Discussionmentioning

confidence: 99%

Cervical Radiculopathy vs Parsonage–Turner Syndrome: A Case Report

Feinberg

Doward

Gonsalves

2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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A 42-year-old recreational cyclist presented with a 3-month history of right-sided neck pain. The patient experienced pain radiating to the right periscapular region and paresthesias in digits 1-3. The onset of the pain was sudden. She described the pain as intermittent and sharp, ranging from 8-10/10 on numeric pain rating scale. The pain was worse at nighttime, often so severe that it would wake her from sleep. She also noted severe headaches and right upper extremity numbness and weakness. She had visited the emergency room twice, both times being admitted to a neurology service because of the severe nature of the pain and what was described as atypical hemiplegia and migraines. A CT scan of the head and cervical spine and an MRI of the cervical spine were normal. The patient was discharged on pain medication, which included prednisone, depakote, zoloft, motrin, and topamax. There was no history of trauma, falls, or any inciting events. She had no history of bowel or bladder incontinence, recent travel, or fever and chills. Her medical history was significant for migraines, right carpal tunnel syndrome, and depression. She was taking lexapro and clonazepam for depression.Physical examination revealed mild limited cervical range of motion with end range axial pain with flexion, extension, and lateral rotation. Spurling maneuver was positive on the right side eliciting pain in digits 1 and 2. Active and passive range of motion of the right shoulder was minimally limited compared to the left (asymptomatic) side. Additional findings included medial winging of the right scapula and mild weakness (4+/5) of the right triceps. Muscle strength throughout the rest of the upper extremities was 5/5. The rest of the physical examination revealed normal muscle bulk and tone, normal sensation, symmetric upper extremity reflexes, and negative Hawkins_, Neer_s, Roos_, Wright_s, and Adson_s provocative tests.Clinical evaluation at this point was suggestive of Parsonage-Turner syndrome vs a cervical radiculopathy, although a broader differential diagnosis was considered (Fig. 1). Electrodiagnostic studies were performed and showed evidence of severe denervation (2+ positive sharp waves and fibs) corresponding to muscles of the right C7 myotome and including the paraspinal muscles, consistent with a right C7 radiculopathy (Fig. 2). Motor unit recruitment was reduced in the involved muscles and there were no polyphasic potentials. An MRI of the cervical spine was repeated and revealed mid to lower cervical spondylosis, moderate left-sided C5/6 foraminal stenosis, and mild right-sided C6/7 foraminal stenosis (Fig. 3). Because the MRI findings did not demonstrate significant nerve root compression, the patient was diagnosed with Parsonage-Turner syndrome and Lyrica was prescribed. Over the next 6 weeks the patient_s symptoms improved but then suddenly worsened.The patient returned for follow-up with complaints of recurrent right neck pain and right upper extremity weakness. Neck range of motion was now normal and Spurling_s maneuve...

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Acute paralytic brachial neuritis

Cited by 80 publications

References 0 publications

Parsonage-Turner Syndrome

Parsonage-Turner Syndrome

Sensory Nerve Abnormalities in Brachial Plexopathy

Cervical Radiculopathy vs Parsonage–Turner Syndrome: A Case Report

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