Neuroimaging of classic neuralgic amyotrophy

Lieba‐Samal, Doris; Jengojan, Suren; Kasprian, Gregor; Wöber, Christian; Bodner, Gerd

doi:10.1002/mus.25147

Cited by 44 publications

(31 citation statements)

References 23 publications

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“…Regarding the ultrasonographic assessment of NA, one of the main messages of our study is that, despite the traditional concept of NA as a “plexitis,” the sonomorphological abnormality with an overall sensitivity of 74% is to be expected in the affected nerve, rather than in the brachial plexus per se . This has been also described in 2 recent, small studies of NA . Therefore, the ultrasonographic examination should focus on the affected nerve and an effort should be made to scan its entire accessible length, including the parent nerve.…”

Section: Discussionmentioning

confidence: 74%

Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations

et al. 2017

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Section: Discussionmentioning

confidence: 74%

Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations

et al. 2017

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“…In neuralgic amyotrophy, nerve inflammation with enlarged CSA can be seen involving the brachial plexus as well as peripheral nerves in the distal upper arm. [105][106][107][108] Focal nerve enlargement can also at times be demonstrated by ultrasound in other axonal inflammatory disorders such as sarcoid neuropathy 109 and neuropathy associated with vasculitis syndromes. 110…”

Section: Acquired Inflammatory Neuropathiesmentioning

confidence: 99%

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Mah

Alfen

2018

Can. J. Neurol. Sci.

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Advances in high-resolution ultrasound have provided clinicians with unique opportunities to study diseases of the peripheral nervous system. Ultrasound complements the clinical and electrophysiology exam by showing the degree of abnormalities in myopathies, as well as spontaneous muscle activities in motor neuron diseases and other disorders. In experienced hands, ultrasound is more sensitive than MRI in detecting peripheral nerve pathologies. It can also guide needle placement for electromyography exam, therapeutic injections, and muscle biopsy. Ultrasound enhances the ability to detect carpal tunnel syndrome and other focal nerve entrapment, as well as pathological nerve enlargements in genetic and acquired neuropathies. Furthermore, ultrasound can potentially be used as a biomarker for muscular dystrophy and spinal muscular atrophy. The combination of electromyography and ultrasound can increase the diagnostic certainty of amyotrophic lateral sclerosis, aid in the localization of brachial plexus or peripheral nerve trauma and allow for surveillance of nerve tumor progression in neurofibromatosis. Potential limitations of ultrasound include an inability to image deeper structures, with lower sensitivities in detecting neuromuscular diseases in young children and those with mitochondrial myopathies, due to subtle changes or early phase of the disease. As well, its utility in detecting critical illness neuromyopathy remains unclear. This review will focus on the clinical applications of neuromuscular ultrasound. The diagnostic values of ultrasound for screening of myopathies, neuropathies, and motor neuron diseases will be presented.

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“…The MRI changes seem to resolve over time, in line with the clinical symptoms . Ultrasonographic studies show focal nerve swelling, which mostly seems to affect the perineural compartment surrounding the fascicles, most often in the roots or proximal brachial plexus elements and in the proximal median and radial nerves. Nerve torsion and constriction have recently been reported as well …”

mentioning

confidence: 74%

Extremely Painful Multifocal Acquired Predominant Axonal Sensorimotor Neuropathy of the Upper Limb

Lieba‐Samal

Eijk

Rosmalen

et al. 2017

J of Ultrasound Medicine

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The differential diagnosis of upper extremity mononeuritis multiplex includes neuralgic amyotrophy, vasculitic neuropathy, and Lewis-Sumner syndrome. We describe 3 patients initially suspected of neuralgic amyotrophy, who had an extremely painful, protracted, progressive disease course, not fitting one of these established diagnoses. Nerve ultrasonography showed focal caliber changes of the roots, plexus, and limb nerves. Electromyography showed predominant multifocal axonopathy. Ongoing autoimmune neuropathy was suspected. Steroid treatment provided temporary relief, and intravenous immunoglobulin A sustained pain decrease and functional improvement. These patients appear to have extremely painful axonal inflammatory neuropathy, with a good response to immune-modulating treatment.

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Neuroimaging of classic neuralgic amyotrophy

Abstract: HRUS and MRI are valuable diagnostic tools in NA. This could change the diagnostic approach from one now focused on excluding other disorders to confirming NA through imaging markers. Muscle Nerve 54: 1079-1085, 2016.

Cited by 44 publications

References 23 publications

Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations

Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Extremely Painful Multifocal Acquired Predominant Axonal Sensorimotor Neuropathy of the Upper Limb

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