Motor root conduction in neuralgic amyotrophy: evidence of proximal conduction block

Lo, Yew‐Long; Mills, Kerry

doi:10.1136/jnnp.66.5.586

Cited by 24 publications

(16 citation statements)

References 37 publications

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“…Although two electrophysiologic studies have shown that the lesions in this syndrome can be very proximal, it has not been possible to distinguish whether the nerve lesions are in individual nerves or in selective fascicles within nerve roots or the brachial plexus. 32,35 Although the latter has long been suggested by experienced clinicians, 11,50 the precise answer remains unclear.…”

Section: Acute Brachial Plexus Neuropathymentioning

confidence: 97%

Peripheral nerve fascicles: Anatomy and clinical relevance

2003

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Within a peripheral nerve, the individual nerve fibers are grouped together in fascicles. Whether there is somatotopic organization within these fascicles has long been of interest, the subject of many investigations, and somewhat controversial. Evidence from diverse sources now points to important somatotopic clustering of nerve fibers within most of the length of the nerve. Information is lacking regarding proximal segments, particularly the plexus and spinal nerve root levels. As a result of this somatotopic arrangement, partial focal nerve lesions can produce restricted clinical deficits that defy the classic rules of localization. Examples of such restricted nerve lesions are provided in this review. Recognition of fascicle somatotopy is also important in the surgical approach to disorders of peripheral nerves.

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Section: Acute Brachial Plexus Neuropathymentioning

confidence: 97%

Peripheral nerve fascicles: Anatomy and clinical relevance

2003

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“…In addition, selective involvement of muscles supplied by the anterior interosseous nerve has long been recognised [15]. Electromyography (EMG) and nerve conduction studies have mainly suggested a process of axonal degeneration at the brachial plexus [4] although recent studies have reported motor conduction block across the brachial plexus [1,11]. Motor conduction block in nerves distal to the brachial plexus has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Acute-onset painful upper limb multifocal demyelinating motor neuropathy

Misra

Walker

2000

Journal of Neurology

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We report three patients who presented with acute onset of shoulder and upper arm pain followed within a few days by predominantly distal upper limb weakness. Nerve conduction studies showed severe and unequivocal focal motor conduction block in the forearm and/or upper arm along with slowing of motor conduction and prolonged F wave responses. Only very mild changes in sensory nerve conduction were found. One patient made partial clinical improvement after 17 months, and there was a significant improvement in the degree of motor conduction block and the motor conduction velocities. A second patient remained unchanged after 5 months. Idiopathic brachial neuritis (IBN) typically presents acutely with brachialgia and acute or subacute non-progressive weakness. Multifocal motor conduction block in nerves in the arm or forearm has not been described in patients with IBN. Multifocal motor conduction block restricted to the upper limbs has been described in focal chronic inflammatory demyelinating polyneuropathy (CIDP) and in multifocal motor neuropathy with multifocal motor conduction block (MMNCB). However, both these conditions have hitherto usually been described as largely painless chronic progressive disorders with a subacute onset. Our patients, with features overlapping MMNCB/CIDP and IBN, represent an as yet unreported clinical variant.

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“…In a few cases of neuralgic amyotrophy evidence of proximal motor conduction block has been provided [2,4] . Watson et al [4] showed a partial conduction block between the cervical spinal roots and axilla in 2 patients 6-8 weeks after onset.…”

Section: Discussionmentioning

confidence: 99%

“…On follow-up examinations on day 54 his moDear Sir, Neuralgic amyotrophy is a well-established clinical syndrome characterized by an acute onset of shoulder and arm pain followed by muscular weakness, wasting and variable sensory loss [1] . Most neurophysiological studies have reported features of axonal degeneration [2] , reflecting terminal pathological results rather than the underlying process. We report a patient with neuralgic amyotrophy who was examined within a week after pain onset.…”

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confidence: 99%