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Recurrent brachial plexus neuropathy.

W G Bradley, R Madrid, D C Thrush

    Brain : a Journal of Neurology
    |September 1, 1975
    PubMed
    Summary
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    This study describes three patients with recurrent brachial plexus neuropathy, distinguishing between neuralgic amyotrophy and other related conditions based on clinical and pathological findings. Familial cases show distinct features from typical neuralgic amyotrophy.

    Area of Science:

    • Neurology
    • Pathology
    • Genetics

    Background:

    • Brachial plexus neuropathy presents with diverse clinical syndromes.
    • Distinguishing between neuralgic amyotrophy and other causes of brachial plexus neuropathy is crucial for accurate diagnosis and management.

    Observation:

    • Three patients with recurrent non-traumatic brachial plexus neuropathy were analyzed, exhibiting varied clinical presentations, pain levels, and family histories.
    • Pathological examination revealed tomaculous neuropathy with myelin sheath swellings and demyelination/remyelination in familial cases.
    • One patient presented with extremely painful attacks consistent with neuralgic amyotrophy, including vagus nerve involvement.

    Findings:

    • Familial cases of brachial plexus neuropathy differ from neuralgic amyotrophy in recurrence frequency, pain severity, extraplexal nerve involvement, and associated anomalies.

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  • The study proposes restricting the term "neuralgic amyotrophy" to acute, painful paralysis without family history or extraplexal lesions.
  • Other presentations suggest distinct underlying disease entities requiring further investigation.

    • Implications:

    • Accurate nosological classification of brachial plexus neuropathy is essential for understanding its diverse etiologies.
    • Further pathological and biochemical studies are needed to differentiate between various forms of brachial plexus neuropathy.
    • Recognizing distinct clinical subgroups can guide targeted research and improve patient care.