MRI Neurography Findings in Patients with Idiopathic Brachial Plexopathy: Correlations with Clinical-neurophysiological Data in Eight Consecutive Cases

Luigetti, Marco; Pravatà, Emanuele; Colosimo, Cesare; Sabatelli, Mario; Masciullo, Marcella; Capone, Fioravante; Monaco, Mauro Lo; Monforte, Mauro; Silvestri, Gabriella; Ricci, Enzo; Pacciani, E; Lazzaro, Vincenzo Di

doi:10.2169/internalmedicine.52.0533

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…Here, the nerves of the plexus also appear thickened with hyperintense signal in T2W images. [525] However, when the patient's clinical profile is reviewed along with MR imaging and electrophysiological findings, the diagnosis of PTS can be reached with ease.…”

Section: Discussionmentioning

confidence: 99%

“…Luigetti et al in their paper have described Magnetic Resonance Neurography (MRN) findings in the brachial plexus in a series of 8 patients with PTS and have found it to be useful in confirming the clinical diagnosis as well as in ruling out other probable causes. [5] Hence, the authors decided to carry out a study which focuses on the pattern of involment of various components of the plexus in PTS by imaging the plexus directly by MRN.…”

Section: Introductionmentioning

confidence: 99%

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MR neurography in Parsonage-Turner syndrome

Upadhyaya

Bansal

et al. 2019

Indian Journal of Radiology and Imaging

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Background and Aims:Parsonage Turner Syndrome is a well known clinical entity. Several excellent articles have succinctly described Magnetic Resonance Imaging (MRI) findings in PTS. However, these articles have inferred neural involvement in PTS based on the patterns of denervation of muscles in the shoulder region. The aim of this study is to directly visualize the distribution and extent of abnormality in MR Neurography (MRN) of the brachial plexus in known cases of brachial plexus neuritis or Parsonage-Turner Syndrome (PTS).Methods:15 patients who were diagnosed with PTS based on clinical and electrophysiological findings participated in the study. MRN of the brachial plexus was done in a 1.5T system using a combination of T1W (T1-weighted), T2W (T2-weighted) fat-saturated, STIR (Short Tau Inversion Recovery), 3D STIR SPACE (Sampling Perfection with Application Optimized Contrasts) and 3D T2W SPACE sequences. Findings were recorded and assessed.Results:The age range of our patients was 7-65 years (mean 37.87 years). Most of the patients had unilateral symptoms. All patients had weakness in shoulder abduction. Other common associated complaints included pain in the shoulder/neck/arm and preceding fever. MRN revealed the percentage of involvement of roots, trunks, cords and terminal branches was 53.3%, 46.7%, 40% and 13.3% respectively. Evidence of muscle denervation in the form of edema, fatty infiltration and atrophy was noted in 8 (53.3%) patients.Conclusion:Most of the patients in this study had unilateral involvement on MRN. The roots were the commonest site of involvement followed by the trunks, cords and terminal branches. C5 was the most commonly involved root.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MR neurography in Parsonage-Turner syndrome

Upadhyaya

Bansal

et al. 2019

Indian Journal of Radiology and Imaging

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“…In the present study, the number of EDXs performed for plexus disorders was relatively low. The use of clinical evaluations and EDX and magnetic resonance neurography is mentioned in the literature [ 23 , 24 ]. Both clinical diagnosis and EDX are required in amyotrophic lateral sclerosis, a motor neuron disease.…”

Section: Discussionmentioning

confidence: 99%

How much does clinical prediagnosis correlate with electrophysiological findings?: a retrospective study

İnceoğlu,

Ayyıldız,

Yılmaz

et al. 2024

JYMS

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Background: Electrodiagnostic testing (EDX) is important in the diagnosis and follow-up of neuropathic and myopathic diseases. This study aimed to demonstrate the compatibility between clinical prediagnosis and electrophysiological findings. Methods: EDX results from 2004 to 2020 at the physical medicine and rehabilitation (PM&R) clinic were screened. Tests with missing data, reevaluation studies, and cases of peripheral facial paralysis were excluded. The clinical prediagnosis and EDX results were recorded, and their compatibility was evaluated. Results: A total of 2,153 tests were included in this study. The mean age was 49.0±13.9 years and 1,533 of them (71.2%) were female. The most frequently referred clinic was the PM&R clinic (90.0%). Numbness (73.6%) was the most common complaint, followed by pain (15.3%) and weakness (13.9%). The most common prediagnosis was entrapment neuropathy (55.3%), radiculopathy (16.1%), and polyneuropathy (15.7%). Carpal tunnel syndrome was the most frequently identified type of entrapment neuropathy (78.3%). Six hundred and seventy EDX results (31.1%) were within normal limits. While the EDX results were consistent with the prediagnosis in 1,328 patients (61.7%), a pathology different from the prediagnosis was detected in 155 patients (7.2%). In the discrepancy group, the most common pathologies were entrapment neuropathy (51.7%), polyneuropathy (17.3%), and radiculopathy (15.1%). The most common neuropathy type was carpal tunnel syndrome (79.3%).Conclusion: After adequate anamnesis and physical and neurological examinations, requesting further appropriate tests will increase the prediagnosis accuracy and prevent unnecessary expenditure of time and labor.

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“…Nevertheless, a conduction block in nerve segments proximal to Erb’s point, not evaluable with conventional NCS,1 could not be excluded. Proximal structures can be explored using either magnetic resonance (MR) neurography2 or nerve ultrasonography. The latter is sensitive and less expensive and so it could be considered as the preferable investigation 3.…”

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confidence: 99%

Brachial palsy after deep sleep

Lazzaro¹,

Giambattistelli²,

Pravatà³

et al. 2014

J Neurol Neurosurg Psychiatry

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A young student presented with left forearm numbness and proximal arm palsy after awaking from benzodiazepine and alcohol consumption-induced deep sleep. The patient had fallen asleep while sitting with the neck leaning on a laptop screen and head tilted left (figure 1). Prior medical history was negative for diabetes mellitus, trauma, neuropathy, chronic alcohol consumption, renal failure or autoimmune disorders. There was no family history of neuropathy. Examination revealed paralysis of the left deltoid, biceps and brachioradialis muscles, mild triceps weakness (4/5 MRC scale), absent biceps tendon reflex and C5-C6 dermatomal hypoesthesia suggesting involvement of the C5-C6-C7 roots or the upper and middle primary trunks of the brachial plexus. Electromyography, performed 3 days after the onset of symptoms, showed no motor unit voluntary recruitment in deltoid, biceps or brachioradialis, and reduced recruitment in triceps. Bilateral upper limb sensory, including lateral antebrachial cutaneous nerve, and motor nerve conduction studies (NCS) were unremarkable. The amplitudes and latencies of compound muscle action potentials recorded from left and right biceps and deltoid muscles were normal and symmetrical even after brachial plexus stimulation at Erb's point.

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MRI Neurography Findings in Patients with Idiopathic Brachial Plexopathy: Correlations with Clinical-neurophysiological Data in Eight Consecutive Cases

Cited by 8 publications

References 21 publications

MR neurography in Parsonage-Turner syndrome

MR neurography in Parsonage-Turner syndrome

How much does clinical prediagnosis correlate with electrophysiological findings?: a retrospective study

Brachial palsy after deep sleep

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