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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
PubMed
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.

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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.

Related Experiment Videos

  • 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.