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Hypertrophic inflammatory neuropathy involving bilateral brachial plexus
M Stumpo1, M P Foschini, M Poppi
1Institute of Neurology, University of Bologna, Italy.
Surgical Neurology
|December 14, 1999
Summary
Hypertrophic inflammatory neuropathy (HIN) is a rare, tumor-like nerve condition. This case highlights its distinct characteristics, differentiating it from other focal neuropathies.
Area of Science:
- Neurology
- Pathology
Background:
- Hypertrophic inflammatory neuropathy (HIN) is a rare, tumor-like, chronic inflammatory, focal or multifocal demyelinating neuropathy.
- Its etiology remains unknown, with a predilection for the brachial plexus.
Observation:
- A 67-year-old man presented with a schwannoma-like nodular mass in the right supraclavicular fossa.
- Histology revealed endoneurial edema, fibrosis, inflammation, and extensive "onion bulb" formations.
- Post-surgery, the patient experienced transient biceps paralysis, followed by bilateral brachial plexus lesions on MRI.
Findings:
- "Onion bulb" formations were confirmed as schwannian cells surrounding demyelinated axons.
- Electrophysiology indicated a bilateral, asymmetrical, primarily demyelinating brachial plexus neuropathy.
- The condition was distinguished from localized hypertrophic neuropathy (LHN).
Implications:
- This case underscores the unique pathological features of HIN.
- Accurate diagnosis is crucial for differentiating HIN from other nerve tumors and neuropathies.
- Further research is needed to elucidate the unknown origin of HIN.