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Updated: May 24, 2025
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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
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Claw Hand in Parsonage Turner syndrome.
Michael E Lazarus1, Tyler B Larsen1,2
1Internal Medicine, Department of Medicine University of California, Los Angeles, CA, USA.
Journal of Brown Hospital Medicine
|March 3, 2025
Summary
An elderly patient developed severe right-hand pain and weakness due to immune-mediated neuralgic amyotrophy. Treatment with intravenous immune globulin (IVIG) showed partial motor improvement, highlighting a rare neurological complication.
Area of Science:
- Neurology
- Immunology
Background:
- Elderly patients with significant smoking history are susceptible to neurological disorders.
- Immune-mediated polyneuropathies can present with acute, severe limb pain and motor deficits.
Observation:
- A patient presented with acute right-hand pain, progressive weakness, and sensory deficits.
- Nerve conduction studies revealed motor-predominant polyneuropathy.
- MRI excluded structural lesions, and positive anti-ganglioside antibodies (GalNAc-GD1a IgG) were detected.
Findings:
- The patient was diagnosed with immune-mediated neuralgic amyotrophy (Parsonage-Turner Syndrome).
- Treatment with intravenous immune globulin (IVIG) resulted in partial motor function recovery over six months.
Implications:
- This case highlights a rare autoimmune neuropathy, potentially triggered by various factors, though not SARS-CoV-2 in this instance.
- Increased reporting of neuralgic amyotrophy during the COVID-19 pandemic warrants awareness among internists.
- Early diagnosis and immunotherapy (IVIG) can lead to partial recovery in immune-mediated neuropathies.
Keywords:
Neuralgic amyotrophyParsonage Turner SyndromeSARS-CoV-2Sudden upper extremity painacute multi-focal motor neuropathyganglioside GD1a antibodyMore Related Videos
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