Neuralgic amyotrophy manifesting as anterior interosseous nerve palsy

Rennels, Glenn D.; Ochoa, José L.

doi:10.1002/mus.880030209

Cited by 69 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, our findings suggest that these cases were suffering from brachial plexus neuritis [14]. Previous reports described conservative treatment with spontaneous recovery occurring up to 2 to 3 years after the onset of the palsy, and the results after conservative treatment are generally good [2,[8][9][10]12,14,16,18,21].…”

Section: Discussionmentioning

confidence: 57%

“…Fearn and Goodfellow [3] were the first to do surgical exploration for the diagnosis and treatment. For electrodiagnosis of the AIN lesions, many previous reports described that the electromyogram revealed fibrillation or sharp wave, or neurogenic recruitment in innervated muscles [4][5][6][7][8][9][10][11][12][13][14][15]. However, there are a few nerve conduction measurements for AIN lesions reported up to the present [16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Retrospective Analysis of Anterior Interosseous Nerve Lesions and Motor Nerve Conduction Measurements

Nobuta¹,

Sato²,

Itoi³

2017

J Neurol Neurophysiol

View full text Add to dashboard Cite

Objective: Anterior interosseous nerve (AIN) lesions are rare and a few nerve conduction measurements have been reported. The purpose of this retrospective study was to assess the diagnostic value of the motor nerve conduction measurements for the AIN lesion and to investigate its electrodiagnostic features. Methods:Twenty-three patients with AIN lesion were reviewed after a mean follow-up of 13 months. Of these 23 cases, a complete palsy of flexor pollicis longus (FPL) and flexor digitorum profundus to the index finger (FDP1) was seen in five, and an isolated palsy of FPL in three and that of FDP1 in two, while pronator quadratus (PQ) was weak in twelve. The compound muscle action potential (CMAP) from the PQ muscle and the FPL muscle were recorded and analyzed. Twenty-two patients were treated conservatively and one underwent surgery.Results: Both PQ-CMAP and FPL-CMAP were recorded in all of the patients initially, and they all showed abnormality in PQ-and/or FPL-CMAP. Delayed latency and / or low amplitude were seen in 21 for PQ-CMAP and in 17 for FPL-CMAP. At the time of final follow-up, an improvement in the muscle strength of FPL, FDP1 and PQ was seen in 11 with the British Medical Research Council (MRC) grade 4 or better (complete recovery), whereas, partial recovery in 11 and unchanged in one. The decrease of amplitude in PQ-CMAP showed a significant difference between the normal PQ strength group and the weak PQ strength group. Conclusion:Recording and analysis of PQ-and FPL-CMAP are simple and safe and are important for the definite electrodiagnosis of AIN lesions. The data suggest that an axonal degeneration is main pathology.

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of Anterior Interosseous Nerve Lesions and Motor Nerve Conduction Measurements

Nobuta¹,

Sato²,

Itoi³

2017

J Neurol Neurophysiol

View full text Add to dashboard Cite

show abstract

“…Spontaneous recovery can take place even after more than 12 months, especially in lesions which are due to neuritis or the paralytic brachial neuritis syndrome (Parsonage et al 1957;Rennels and Ochoa 1980;Hill et al 1985;Seror 1986b). This is consistent with my results and those reported by Spinner (1970) and in other series managed without surgery (Kiloh and Nevin 1952;Parsonage et al 1957;Lake 1974;Nakano et al 1977;Hill et al 1985;Gaitzsch and Chamay 1986), and suggests that in the absence of trauma or another mechanical aetiology, surgery should not be undertaken for at least a year.…”

Section: Resultsmentioning

confidence: 99%

“…Five of the 14 cases reported here were related to mechanical causes: one after a forearm fracture (case 11), three after minor injuries (cases 3, 5 and 10) and one due to sleeping with the head on the forearm causing local pressure (case 1). Six had the characteristics of neuritis (Kiloh and Nevin 1952;Parsonage et al 1957;Rennels and Ochoa 1980;Gaitzsch and Chamay 1986): two (cases 12 and 13) occurred after severe influenza, two (cases 6 and 9) had associated involvement of the shoulder girdle muscle and were considered to be cases of neuralgic amyotrophy, and two cases localised to the index finger had an unknown cause. Three were associated with forearm oedema due to postoperative intravenous infusion in two and to a humeral fracture in one, but post-traumatic neuralgic amyotrophy may be involved (Kiloh and Nevin 1952;Parsonage et al 1957).…”

Section: Resultsmentioning

confidence: 99%

Anterior Interosseous Nerve Lesions

Séror¹

1996

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

Lesions of the anterior interosseous nerve in the forearm are rare and often misdiagnosed as tendon injuries. A consecutive series of 13 patients with this condition referred for electrodiagnosis is reviewed. Only three had originally a correct clinical diagnosis and three were initially considered to have tendon ruptures.Five cases were of mechanical origin and seven due to 'neuritis'. All showed electrophysiological abnormalities, most commonly involving the pronator quadratus. Late spontaneous recovery was common, and only one case had surgical exploration.

show abstract

“…The suprascapular, long thoracic, and axillary nerves are the most commonly involved peripheral nerves [21,27,30,38]. The musculocutaneous, anterior interosseous, ulnar, median, and phrenic nerves were also reported [6,19,23,28].…”

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

View full text Add to dashboard Cite

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...

show abstract

Neuralgic amyotrophy manifesting as anterior interosseous nerve palsy

Cited by 69 publications

References 15 publications

Retrospective Analysis of Anterior Interosseous Nerve Lesions and Motor Nerve Conduction Measurements

Retrospective Analysis of Anterior Interosseous Nerve Lesions and Motor Nerve Conduction Measurements

Anterior Interosseous Nerve Lesions

Cervical Radiculopathy vs Parsonage–Turner Syndrome: A Case Report

Contact Info

Product

Resources

About