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[Neuralgic amyotrophy]

B Hassel1, S Sawcer

  • 1Babraham Institute, Cambridge, England.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|April 9, 1998
PubMed
Summary

Neuralgic amyotrophy, an inflammatory brachial plexus condition, causes severe shoulder pain and paralysis. Early symptoms can mimic musculoskeletal disorders, highlighting the need for accurate diagnosis.

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Area of Science:

  • Neurology
  • Immunology

Background:

  • Neuralgic amyotrophy is an idiopathic inflammatory neuropathy affecting the brachial plexus.
  • It typically presents with acute shoulder girdle pain, followed by sensory and motor deficits.

Observation:

  • A 38-year-old male presented with bilateral shoulder pain, right arm hypoesthesia, and paresthesias.
  • Initial misdiagnosis as shoulder capsulitis led to ineffective naproxen treatment.

Findings:

  • The patient developed acute flaccid paralysis in the right biceps, left spinati, and serratus anterior muscles eight days after symptom onset.
  • Gradual, spontaneous improvement in sensation and muscle strength occurred over several months without specific treatment.

Implications:

  • This case underscores the diagnostic challenges of neuralgic amyotrophy, particularly its initial presentation mimicking musculoskeletal conditions.
  • The natural history suggests potential for spontaneous recovery, even in severe presentations, emphasizing conservative management in early stages.

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