Clinico-diagnostic features of neuralgic amyotrophy in childhood

Rotondo, Eleonora; Pellegrino, Noemi; Battista, Caterina Di; Graziosi, Alessandro; Stefano, Vincenzo Di; Striano, Pasquale

doi:10.1007/s10072-020-04314-8

Cited by 14 publications

(13 citation statements)

References 41 publications

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“…Pediatric NA is similar to the adult phenotype, but may be harder to recognize, especially in the very young who cannot verbally communicate their symptoms [27,28,29 ▪ ]. Painless episodes seem more common in children, and a right-sided predominance of the attacks is not yet evident in preschoolers [27,30].…”

Section: Pediatric Neuralgic Amyotrophymentioning

confidence: 99%

Neuralgic amyotrophy

IJspeert

Janssen

Alfen

2021

Current Opinion in Neurology

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Purpose of reviewThis review focuses on the current insights and developments in neuralgic amyotrophy (NA), an auto-immune multifocal peripheral nervous system disorder that leaves many patients permanently impaired if not recognized and treated properly.Recent findingsNA is not as rare as previously thought. The phenotype is broad, and recent nerve imaging developments suggest that NA is the most common cause of acute anterior or posterior interosseous nerve palsy. Phrenic nerve involvement occurs in 8% of all NA patients, often with debilitating consequences. Acute phase treatment of NA with steroids or i.v. immunoglobulin may benefit patients. Long-term consequences are the rule, and persisting symptoms are mainly caused by a combination of decreased endurance in the affected nerves and an altered posture and movement pattern, not by the axonal damage itself. Patients benefit from specific rehabilitation treatment. For nerves that do not recover, surgery may be an option.SummaryNA is not uncommon, and has a long-term impact on patients’ well-being. Early immunomodulating treatment, and identifying phrenic neuropathy or complete nerve paralysis is important for optimal recovery. For persistent symptoms a specific treatment strategy aiming at regaining an energy balance and well-coordinated scapular movement are paramount.

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Section: Pediatric Neuralgic Amyotrophymentioning

confidence: 99%

Neuralgic amyotrophy

IJspeert

Janssen

Alfen

2021

Current Opinion in Neurology

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“…PTS is most commonly reported in young adults, and reports in children are rare. In children it shows a biphasic distribution; in neonates (,8 weeks) and adolescents [9][10][11][12][13][14] . The male-tofemale ratio is 2.4/1.…”

Section: Discussionmentioning

confidence: 99%

Parsonage-Turner Syndrome in a 9-Year-Old Boy

Donadeu Sánchez,

Arvinius,

Fernandez Fernandez-Arroyo

et al. 2023

JBJS Journal of Orthopaedics for Physician Assistants

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We present the case of a 9-year-old boy who presented to the emergency department with acute shoulder pain that progressed to right arm radialis paralysis. After a magnetic resonance imaging, he was diagnosed with Parsonage-Turner syndrome and treated accordingly. Parsonage-Turner syndrome (PTS) is an uncommon disorder in children. Only case reports or small series have being published around this topic in the pediatric population. Sudden pain with loss of strength on the upper extremities after a viral infection should make physicians include PTS in the diagnosis. Current treatment includes pain relief and physiotherapy, to regain as much function as possible.

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“…This review highlights the importance of performing a dynamic flexion and extension cervical MRI in young patients with otherwise unexplained progressive weakness and amyotrophy of the upper limb. In this particular setting, the dynamic flexion and extension MRI is the best diagnostic tool for the diagnosis of HD and it is also useful in the differential diagnosis between HD, incurable, and progressive MNDs, such as distal SMA, ALS, PLS, post‐polio syndrome, and curable conditions, such as cervical myelopathy, syringomyelia, multifocal motor neuropathy with conduction block, and neuralgic amyotrophy 36 . At difference with incurable MNDs and degenerative diseases that are characterized by a poor prognosis, the early diagnosis of HD allows to prompt treatment, thus favoring a good recovery.…”

Section: Discussionmentioning

confidence: 99%

Hirayama disease: Nosological classification and neuroimaging clues for diagnosis

Iacono

Stefano

Gagliardo

et al. 2022

Journal of Neuroimaging

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Hirayama disease (HD) is a rare, benign, and nonprogressive motor neuron disease (MND) affecting the upper limbs. It usually presents with weakness and amyotrophy in a single upper extremity with an insidious onset between adolescence and the third decade of life. Since its description in 1959, HD has been known under several names and eponyms in Europe and in Asian countries probably due to its heterogeneous clinical features.Thus, the unclear nosological classification makes challenging the differential diagnosis between HD and other neuromuscular conditions, such as MNDs. However, apart from the nosological difficulties and the lack of evidence-based guideline for diagnosis, the neuroimaging is the mainstay for the diagnosis of HD. Indeed, the specific findings on cervical flexion MRI usually lead to a prompt diagnosis. Here, we reviewed the nosological classifications of HD and its neuroimaging features. Also, we report a case of a 18-year-old boy who presented to our Clinic complaining of muscle weakness of the left distal upper limb without other neurological signs. The cervical MRI, in the neutral position, revealed a high T2 signal intensity in the C5-C7 cervical myelomeres as well as the loss of cervical lordosis, whereas, during neck flexion, it showed the anterior displacement of the posterior dura ad the post-gadolinium T1-weighted imaging enhancement of the posterior epidural plexus. These findings are typical for HD allowing the diagnosis as well as the differential diagnosis from other neuromuscular diseases.

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Clinico-diagnostic features of neuralgic amyotrophy in childhood

Cited by 14 publications

References 41 publications

Neuralgic amyotrophy

Neuralgic amyotrophy

Parsonage-Turner Syndrome in a 9-Year-Old Boy

Hirayama disease: Nosological classification and neuroimaging clues for diagnosis

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