Residual Complaints After Neuralgic Amyotrophy

Cup, Edith; IJspeert, Jos; Janssen, Renske; Bussemaker-Beumer, Chaska; Jacobs, Joost; Pieterse, Allan J.; Linde, Harmen van der; Alfen, Nens van

doi:10.1016/j.apmr.2012.07.014

Cited by 58 publications

(99 citation statements)

References 14 publications

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“…Contrary to earlier assumptions, a limited passive range of glenohumeral motion is also often present as a complication in patients with definite neuralgic amyotrophy. This most likely reflects the strong association between scapulothoracic dyskinesia and the risk of glenohumeral complications [4]. Table 4.…”

Section: Discussionmentioning

confidence: 99%

“…Recovery is usually slow over the course of one to two years, with a large subset of patients at risk for developing long term complaints [2][3][4]. Recognition of the disorder as a distinct clinical entity has proved challenging for primary care physicians and neurologists, especially with the various clinical phenotypes within the spectrum of neuralgic amyotrophy, such as painless episodes and episodes that involve the lower brachial plexus or other peripheral nerves [1].…”

Section: Introductionmentioning

confidence: 99%

“…As it is likely that neuralgic amyotrophy attacks are ultimately induced by an auto-immune response to the peripheral nervous system [1][2][3][4][5], efforts have been undertaken to attempt treatment in the acute phase with immunomodulants such as corticosteroids or iv gammaglobuline [6][7][8][9][10][11]. Unfortunately, a randomized controlled trial of corticosteroids failed because it proved impossible to recruit the needed number of participants within the three-year trial period.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Incidence of neuralgic amyotrophy (Parsonage–Turner syndrome) in a primary care setting: A prospective cohort study

Alfen

Groothuis

Nobacht³

et al. 2015

Neuromuscular Disorders

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ObjectiveNeuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting. MethodsIn a prospective cohort study during the year 2012 we registered all new cases of neck, shoulder or arm complaints from two large primary care centers serving a population of 14,118. Prior to study, general practitioners received a short training on how to diagnose classic neuralgic amyotrophy. Neuralgic amyotrophy was defined according to published criteria irrespective of family history. Only patients with a classic phenotype were counted as definite cases. After inclusion, patients with suspected neuralgic amyotrophy who had not yet seen a neurologist were offered neurologic evaluation for diagnostic confirmation. ResultsOf the 492 patients identified with new onset neck, shoulder or arm complaints, 34 were suspected of having neuralgic amyotrophy. After neurologic evaluation the diagnosis was confirmed in 14 patients. This amounts to a one-year incidence rate for classic neuralgic amyotrophy of 1 per 1000. Data Availability Statement: No centralized data collection was available for this study. Data were collected in an anonymized digital datafile and stored locally by the study group. The primary data file for this study is available as S1 Datafile.Funding: This study was sponsored by an unsolicited and unconditional gift from the Dutch Rare Diseases Fund (Stichting Zeldzame Ziekten Fonds; www.zzf.nl) and the ZABAWAS Foundation (www. zabawas.nl). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ConclusionsOur findings suggest that neuralgic amyotrophy is 30-50 times more common than previously thought. Unawareness of the disorder and its clinical presentation seems the most likely explanation for this difference. An incidence rate of 1 per 1000 and the long-term sequelae many patients suffer warrant more vigilance in diagnosing the disorder, to pave the way for timely treatment and prevent complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence of neuralgic amyotrophy (Parsonage–Turner syndrome) in a primary care setting: A prospective cohort study

Alfen

Groothuis

Nobacht³

et al. 2015

Neuromuscular Disorders

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“…2,9 However, recent studies in specialist centers have demonstrated a variance in disease burden. 1,13 These should be interpreted with caution, because specialist centers are dealing with exceptional cases. Long-term residual pain was reported in up to 90% (n = 48) of patients in one study.…”

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confidence: 97%

“…1,[11][12][13][14][15] A Cochrane Review 16 of the treatment of NA took place in 2009; however, 2 of the 3 review authors were also from Nijmegen. This illustrates a need for research to take place outside of this 1 neurology center to give readers the opportunity to appraise current understanding.…”

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confidence: 99%

Neuralgic amyotrophy is not the most common neurologic disorder of the shoulder: a 78-month prospective study of 60 neurologic shoulder patients in a specialist shoulder clinic

Clarke

Torrance²,

McIntosh

et al. 2016

Journal of Shoulder and Elbow Surgery

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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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Residual Complaints After Neuralgic Amyotrophy

Cited by 58 publications

References 14 publications

Incidence of neuralgic amyotrophy (Parsonage–Turner syndrome) in a primary care setting: A prospective cohort study

Incidence of neuralgic amyotrophy (Parsonage–Turner syndrome) in a primary care setting: A prospective cohort study

Neuralgic amyotrophy is not the most common neurologic disorder of the shoulder: a 78-month prospective study of 60 neurologic shoulder patients in a specialist shoulder clinic

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

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