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Neuralgic amyotrophy: variable expression in 40 patients.

A Cruz-Martínez1, M Barrio, J Arpa

  • 1Unidad de Electromiografía, Hospital La Luz, Madrid, Spain.

Journal of the Peripheral Nervous System : JPNS
|October 9, 2002
PubMed
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Neuralgic amyotrophy (NA) is a distinct nerve condition characterized by sudden pain and weakness, often affecting the shoulder. Most patients experience good recovery, suggesting a favorable prognosis for this axonal neuropathy.

Area of Science:

  • Neurology
  • Peripheral Nerve Disorders

Background:

  • Neuralgic amyotrophy (NA) is a rare neurological disorder.
  • Understanding its diverse clinical presentations and progression is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the disease diversity, lesion localization, and progression patterns in patients with neuralgic amyotrophy.
  • To characterize the clinical and electrophysiological findings of NA.

Main Methods:

  • Clinical examination of 40 patients with NA, assessing muscle atrophy, weakness, and sensory impairment.
  • Electrophysiological studies including needle EMG and nerve conduction velocities.
  • Exclusion of other conditions through comprehensive clinical, electrophysiological, laboratory, and radiological assessments.
  • Follow-up of 22 patients over 2 years to observe disease progression and recovery.

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Main Results:

  • Sudden onset of pain followed by weakness, predominantly in proximal shoulder muscles, was the initial symptom in all cases.
  • Electrophysiological findings indicated axonal lesions, presenting as mononeuritis or mononeuropathy multiplex.
  • Unusual nerve involvements, including cranial nerves (VII, XI), phrenic, and lateral antebrachial cutaneous nerves, were observed.
  • Good functional recovery occurred at variable times, even in a patient with co-existing myotonic dystrophy (MD).

Conclusions:

  • Neuralgic amyotrophy is a well-defined entity with variable clinical manifestations, consistent with axonal mononeuropathy or mononeuropathy multiplex.
  • The overall prognosis for NA is generally good, with significant functional recovery observed.
  • The study suggests that dystrophic muscles may retain the capacity to support regenerating nerve sprouts.