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Results for “Brachial Plexus Neuritis”

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At least 19 recordsLinked to original sources

Acute 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. Magnetic resonance imaging of the shoulder and upper arm musculature may reveal denervation within days, allowing prompt diagnosis. Electromyography, conducted three to four weeks after the onset of symptoms, can localize the lesion and help confirm the diagnosis. 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.

Acute Disease↗

Herpes zoster brachial plexus neuritis.

This is the first report of brachial plexus inflammation associated with clinical herpes zoster paresis. A 78-year-old female with a 3-week history of herpes zoster of the C4, C5, and C6 dermatomes developed left upper arm monoplegia. She died from an acute myocardial infarction. Post-mortem provided a rare opportunity to study the neuropathology of herpes zoster motor involvement. Histology of the brachial plexus showed extensive lymphocytic infiltration, myelin breakdown, and preservation of axons without vasculitis. The cervical spinal cord showed perivascular lymphocytic cuffing and no anterior horn necrosis. We suggest, the brachial plexus inflammation was a distal extension of a dorsal ganglionitis. Brachial plexus neuritis may be a direct cause of reversible upper limb paresis in herpes zoster. We demonstrate the motor neuropathy is an inflammatory demyelinative process consistent with the recovery observed in a number of patients. We postulate post-herpetic neuralgia may be related to an ongoing inflammatory process.

Aged↗

Acute bilateral brachial plexus neuritis associated with hypersensitivity vasculitis. A case report and review of literature.

The occurrence of brachial plexus neuritis during the acute phase of vasculitis is uncommon. We describe a patient with a long history of rhinitis and a recent onset of asthma, who developed purpuric skin lesions, abdominal pain, eosinophilia and brachial neuritis along with evidence of sacral plexus neuropathy. High dose steroids and cyclophosphamide induced a remission. He stopped all medications after 3 years and after 6 years the patient has some fixed minimal residual neurological deficit. The importance of aggressive therapy in treating extensive polyneuropathy during the acute phase of hypersensitivity vasculitis is raised. A possible cytotoxic role of eosinophils in the pathological process is suggested.

Acute Disease↗

Bilateral brachial plexus neuritis following parvovirus B19 and cytomegalovirus infection.

A man, 23 years of age, had a typical erythema infectiosum, complicated by a severe bilateral brachial plexus neuritis. Motor function recovered slowly and only partially after 6 months. An infection by human parvovirus B19 was demonstrated, with strongly positive and gradually declining IgM antibodies and viral DNA detectable in serum for more than 3 months. There was also clear evidence of a recent infection by cytomegalovirus. The interaction between these two viruses could be responsible for this rare and severe complication of common infections in this patient.

Adult↗

Brachial plexus neuritis and fatal hemorrhage following Aspergillus infection of a Hickman catheter.

A patient with relapse of acute granulocytic leukemia developed an Aspergillus infection along the subcutaneous tract of a silicone rubber indwelling central venous catheter. The infection invaded the brachial plexus resulting in paralysis of the right upper extremity and subsequently invaded a major artery of the arm resulting in the demise of the patient. Both an infectious brachial plexus neuritis and fatal hemorrhage secondary to a Hickman catheter are apparently rare.

Antineoplastic Agents↗

[Monoparesis due to the brachial plexus neuritis by herpes zoster virus--report of a case].

A 73-year-old woman suffering from the acute onset monoparesis of her right arm which followed the skin eruption with mild sensory disturbance of right C4-6 level, was reported. Electrophysiological examinations revealed the brachial plexus neuritis and axonal degeneration of the proximal portion, with the evidence of herpes zoster infection. Her paresis of the right arm gradually improved without any medication during her hospital course. It was concluded that herpes zoster should be considered to be one of the causes of acute onset brachial plexopathy.

Aged↗

Hypertrophic brachial plexus neuritis: a pathological study of two cases.

Two patients with brachial plexus neuropathy had recurrent symptoms for years that culminated in the development of a painful lower cervical mass. On macroscopic examination the affected nerves had a fusiform segmental enlargement, suggestive of a nerve sheath tumor, that was excised. Histologically, marked endoneurial edema, florid focal chronic inflammation, extensive onion bulb formation, and perineurial sparing were seen. Electron microscopic studies on one patient revealed microvasculitis; frequent tubuloreticular inclusions in endothelial cells, histiocytes, and lymphocytes; and cylindrical confronting cisternae in lymphocytes. We conclude that some cases of recurrent brachial plexus neuropathy are due to a localized chronic inflammation that may be related to autoimmunity or to a viral infection.

Adult↗

[A case of subacute necrotizing lymphadenitis complicated with brachial plexus neuritis].

A 22-year-old female noted a low grade fever and swelling of the cervical lymph nodes in May 1997, and later developed a dry cough. She was diagnosed to have interstitial pneumonitis, and then administration of corticosteroids alleviated her symptoms. On February 6, 1998, however, a high fever recurred and her swollen cervical lymph node on the right side was biopsied on February 9, 1998. A histological examination revealed an increased number of histiocytes and karyorrhexis of the lymphocytes in the paracortical areas, and she was therefore diagnosed to have histiocytic necrotizing lymphadenitis. She could not fully elevate her arm on February 16, 1998. On admission, her cervical lymph node was swollen on the left side. A neurological examination revealed a marked weakness of the right deltoid muscle, moderate weakness of the right latissimus dorsi, triceps and brachioradialis muscles and also a mild weakness of the serratus anterior, supra- and infra-spinatus, and biceps brachii muscles. The muscle power of the other muscles were normal and no muscle atrophy was evident. Winging of the right scapula was observed. The deep tendon reflexes were normal in all four limbs, and her sensation was also normal. No cerebellar sign was found. The Jackson, Spurling, Allen, Morley and Adson tests were all negative. ESR was mildly elevated to 18 mm/hr, but CRP was negative. RF, ANA and anti-SS-A and SS-B antibodies were positive, whereas LE-test, direct and indirect Coombs tests and other autoantibodies were negative. Needle EMG disclosed fasciculation potentials in the right triceps muscle and polyphasic waves in the right deltoid muscle. MRI showed gadolinium-enhancement of the right brachial plexus. Although an abnormal accumulation of gallium was detected in the right parotid and bilateral submandibular glands, no sicca symptoms were found and the Schirmer test findings were normal. Oral prednisolone (50 mg/day with gradual tapering) alleviated both her symptoms and the gadolinium-enhancement of the right brachial plexus. As a result, her right upper limb paresis was thus considered to have been caused by right brachial plexus neuritis, which was probably associated with histocytic necrotizing lymphadentis. Although acute cerebellar ataxia and meningitis have previously been reported to be complicated with histiocytic necrotizing lymphadenitis, this is the first report to describe the complication of peripheral neuritis with this condition.

Adult↗