Articles: brachial-plexus-neuritis-diagnosis.
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American family physician · Nov 2000
Review Case ReportsAcute brachial plexus neuritis: an uncommon cause of shoulder pain.
Patients with acute brachial plexus neuritis are often misdiagnosed as having cervical radiculopathy. Acute brachial plexus neuritis is an uncommon disorder characterized by severe shoulder and upper arm pain followed by marked upper arm weakness. The temporal profile of pain preceding weakness is important in establishing a prompt diagnosis and differentiating acute brachial plexus neuritis from cervical radiculopathy. ⋯ Treatment includes analgesics and physical therapy, with resolution of symptoms usually occurring in three to four months. Patients with cervical radiculopathy present with simultaneous pain and neurologic deficits that fit a nerve root pattern. This differentiation is important to avoid unnecessary surgery for cervical spondylotic changes in a patient with a plexitis.
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Brachial plexus neuritis is a rare neurologic disease that may be overlooked in emergency medicine because other conditions are much more common. We report a case of brachial plexus neuropathy due to cytomegalovirus infection. The diagnosis was based on history, clinical findings, laboratory tests, and electromyography. Early diagnosis and adequate treatment is important to avoid unnecessary investigation, prevent complications (especially adhesive capsulitis of the shoulder), and reassure the patient.
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Two cases of neuralgic amyotrophy occurred 10 and 15 days after delivery, performed with a peridural anesthesia. The initial diagnosis was a brachial plexus stretching during the labor, even though the first symptoms occurred at least 10 days after the delivery. ⋯ Better knowledge of this pathology should allow an earlier diagnosis and provide reassurance for the patient concerning delayed but almost constant recovery (90%). This also should help prevent unnecessary complementary examinations and surgery, which is never recommended.
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Tidsskr. Nor. Laegeforen. · May 1998
Case Reports[Neuralgic amyotrophy or an isolated lesion of the anterior interosseal nerve?].
In this article we describe five patients with acute or subacute weakness of flexor pollicis longus and flexor digitorum profundus. A possible diagnosis of an isolated lesion (entrapment) of the anterior interosseus nerve was considered. However, clinical and neurophysiological findings suggested a diagnosis of neuralgic amyotrophy. ⋯ One patient was operated upon and entrapment was not observed during surgery. Reinnervation was not seen after five months, but was noted in three patients who were investigated 13, 13.5, and 30.5 months after the onset. Thus, the prognosis in this unusual form of neuralgic amyotrophy seems to be rather good, and the length of time before reinnervation supports the theory that the site of the lesion must be located proximally, e.g. in the brachial plexus.