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[Horton's disease revealed by brachial C5 plexopathy]
S Blaise1, E Liozon, S Nadalon
1Service de médecine interne A, hôpital universitaire Dupuytren, 87042 Limoges, France.
La Revue De Medecine Interne
|June 15, 2005
Summary
Giant cell arteritis (TA) can cause rare C5 brachial plexopathy, a shoulder palsy. Prompt corticosteroid treatment leads to good functional recovery, highlighting TA as a key consideration in relevant neurological cases.
Area of Science:
- Neurology
- Rheumatology
- Vascular Inflammation
Background:
- Giant cell arteritis (TA) is an uncommon cause of brachial plexopathy or cervical radiculopathy.
- Shoulder palsy due to C5 involvement is a rare manifestation of TA.
Observation:
- A 67-year-old woman presented with acute neurological deficits including trigeminal neuralgia, masticatory palsy, dysphagia, and left C5 plexitis.
- Temporal artery biopsy confirmed giant cell arteritis.
- Neurological deficits improved significantly with high-dose corticosteroid therapy, with full shoulder strength recovery in 6 months.
Findings:
- Review of 23 additional cases revealed TA-associated C5 radiculopathy/plexopathy can be isolated or part of mononeuritis multiplex.
- Affected patients were middle-aged (mean age 67), with 54% being male.
- The pathophysiology remains unclear, but prognosis with corticosteroids is favorable.
Implications:
- Giant cell arteritis should be suspected in middle-aged or elderly patients with C5 radiculopathy/plexopathy and elevated inflammatory markers.
- Early diagnosis and treatment of TA are crucial for managing these rare neurological complications.
- Corticosteroid therapy is effective in improving neurological outcomes in TA-related brachial plexopathy.