Chronic demyelinating hypertrophic brachial plexus neuropathy
P Y Van den Bergh1, J L Thonnard, T Duprez
1Department of Neurology, Cliniques Universitaires St-Luc, University of Louvain, 10 Avenue Hippocrate, B-1200 Brussels, Belgium. vandenbergh@nchm.ucl.ac.be
Muscle & Nerve
|January 20, 2000
Summary
A patient experienced a progressive sensorimotor deficit due to brachial plexus hypertrophy. Treatment with intravenous immunoglobulin resulted in a complete recovery, highlighting a potential presentation of chronic inflammatory demyelinating polyradiculoneuropathy.
Area of Science:
- Neurology
- Immunology
Background:
- Unilateral, chronic, progressive upper limb sensorimotor deficits can indicate underlying neuropathies.
- Brachial plexus involvement presents diagnostic challenges, requiring advanced imaging and electrophysiological studies.
Observation:
- A patient presented with a painless, progressive, unilateral upper limb sensorimotor deficit.
- Electrophysiology revealed a focal demyelinating neuropathy with significant conduction block at the brachial plexus.
- Magnetic resonance imaging demonstrated marked brachial plexus hypertrophy.
Findings:
- The patient achieved rapid and complete recovery following treatment with intravenous immunoglobulin.
- Sustained recovery was maintained through intermittent intravenous immunoglobulin perfusions.
- Hypertrophic brachial plexus neuropathy was identified as a potential manifestation of focal chronic inflammatory demyelinating polyradiculoneuropathy.
Implications:
- This case underscores that brachial plexus hypertrophy can be a sign of focal chronic inflammatory demyelinating polyradiculoneuropathy.
- Objective hand function assessment is crucial for monitoring treatment efficacy and optimizing therapeutic strategies.
- Early diagnosis and immunomodulatory treatment can lead to favorable outcomes in such neuropathies.
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