Idiopathic Neuralgic Amyotrophy: An Illustrative Case Report

Rix, George D.W.; Rothman, Edward H.; Robinson, Aidan W.D.

doi:10.1016/j.jmpt.2005.11.008

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…Gardner et al (2005) determined the location of a danger zone (12.2-14.8 cm distal to the greater tuberosity along the medial border of the humeral shaft) where the MC could be injured during helical plating of the proximal humerus as a consequence of percutaneous screw placement. Idiopathic neuralgic amyotrophy, a rare disorder of unknown etiology may also affect the musculocutaneous nerve (Rix et al, 2006) though it is not its typical presentation.…”

Section: Clinical Importancementioning

confidence: 99%

Classifying musculocutaneous nerve variations

2009

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A total of 56 upper limbs from fetuses and adult cadavers were dissected to record anatomical variations in the musculocutaneous nerve (MC). A systematic literature review was performed to identify current classifications of MC variations. Communications were seen between the MC and median nerves in 53.6% of the dissections from which 84.6% were proximal, 7.7% distal, and 7.7% had one proximal and one distal communication to the point of entry of the MC into coracobrachialis muscle. In six out of 54 dissections where the MC was present, the nerve did not pierce the coracobrachialis muscle. In two cases, the MC was absent and in one case the MC and the median nerve had a distal origin. This article describes current classifications of MC variations and their problems. A new classification is proposed combining preexisting ones into an integrated and more detailed overview. Clinical manifestations of isolated MC injury with and without the presence of anatomical variations are thoroughly discussed. The knowledge of these variations will allow physicians to correctly interpret anomalous innervation patterns of the upper limb.

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Section: Clinical Importancementioning

confidence: 99%

Classifying musculocutaneous nerve variations

2009

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“…Trauma is the most common cause of brachial plexopathy, while the most common cause of non-traumatic brachial plexopathy is idiopathic brachial neuritis, namely NA 10) . To diagnose NA, medical history taking and physical examination are critical 14) . The classic triad of NA symptoms is pain, weakness, and sensory loss 6,11,15,19) .…”

Section: Discussionmentioning

confidence: 99%

“…It is especially difficult to distinguish NA from cervical radiculopathy in the acute phase of NA 14) . We initially misdiagnosed six patients (60%) and cervical spine MRI was performed for four patients.…”

Section: Discussionmentioning

confidence: 99%

“…Precipitating factors include infectious diseases, connective tissue diseases, immunizations/medications, pregnancy, and surgical operations; however, approximately 54% of patients have no known precipitating factors 10,11,15,19) . Diagnosis is based on the patient's medical history, clinical symptoms, and physical examination results 14,22) . The most helpful diagnostic modalities are neurophysiologic and neuroradiologic studies 5,7,10,14) .…”

Section: Introductionmentioning

confidence: 99%

“…Diagnosis is based on the patient's medical history, clinical symptoms, and physical examination results 14,22) . The most helpful diagnostic modalities are neurophysiologic and neuroradiologic studies 5,7,10,14) . However, the initial symptoms of NA are very similar to the symptoms of other neurological diseases and shoulder disorders.…”

Section: Introductionmentioning

confidence: 99%

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Neuroradiologic and Neurophysiologic Findings of Neuralgic Amyotrophy

Cho

Heo

et al. 2010

J Korean Neurosurg Soc

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Objective : Neuralgic amyotrophy (NA) is a distinct clinical syndrome that is characterized by the acute onset of shoulder and arm pain, weakness, and sensory loss. The purpose of this study was to assess the clinical characteristics of NA and to determine appropriate diagnostic modalities. Methods : We reviewed the medical and radiologic records of 10 patients diagnosed with NA retrospectively. Neurophysiologic studies were performed in all patients and magnetic resonance neurography was performed in the last three patients. Results : A total of 10 patients were enrolled in our study. All patients had clinical findings compatible with NA. The most common clinical presentation was severe shoulder pain and weakness in seven patients (70%). Neurophysiologic study results were abnormal in all patients. Brachial plexus magnetic resonance neurography showed that the affected brachial plexus showed a thickened and hyper-intense trunk. All patients were managed conservatively with analgesics and physical therapy. The pain and paralysis of all patients improved clinically within 6 months of the initiation of treatment. Conclusion : NA is a rare disease but the symptoms of NA can mimic those of other diseases. Neurophysiologic studies and magnetic resonance neurography are extremely useful tools for the diagnosis of NA. KEY WORDS :Neuralgic amyotrophy˙ Brachial plexus˙ Diagnosis˙ Neurophysiology˙ Magnetic resonance imaging.

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