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Neuralgic amyotrophy

Miriam Fritz, Benjamin Berger, Mathias Schemmerer, Dominique Endres, Jürgen J Wenzel, Oliver Stich, Marcus Panning
There is growing evidence that hepatitis E virus (HEV) infection can present with extrahepatic manifestations including neurological disorders. Among these, neuralgic amyotrophy (NA) has been reported to occur in some industrialized countries. We investigated 35 patients with NA and a control group for markers of HEV infection. Acute HEV infection was found in NA patients only and was associated with an inflammatory response in the central nervous system. Shedding of HEV RNA into the cerebrospinal fluid and intrathecal production of anti-HEV IgM occurred in one patient suggesting that HEV is neurotropic...
March 14, 2018: Journal of Infectious Diseases
Brenda C M De Winter, Dennis A Hesselink, Nassim Kamar
Hepatitis E virus (HEV) is the most common cause of viral hepatitis worldwide. Genotypes 1 and 2 (GT1 and GT2) are mainly present in developing countries, while GT3 and GT4 are prevalent in developed and high-income countries. In the majority of cases, HEV causes a self-limiting hepatitis. GT3 and GT4 can be responsible for a chronic hepatitis that can lead to cirrhosis in immunocompromized patients, i.e. solid-organ- and stem-cell-transplant-patients, human immunodeficiency virus-infected patients, and patients receiving chemotherapy or immunotherapy...
February 27, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Renske M J Janssen, Ton Satink, Jos Ijspeert, Nens van Alfen, Jan T Groothuis, Tanya L Packer, Edith H C Cup
PURPOSE: There is lack of knowledge, evidence, and guidelines for rehabilitation interventions for persons with neuralgic amyotrophy (NA) or brachial plexus pathology. A first pilot study, evaluating the effect of an integrated rehabilitation programme, showed improvements in activity and participation levels. AIM: To gain insight, from the perspective of patients and therapists, into the critical ingredients of the programme, that contributed to improvements in activity and participation...
January 31, 2018: Disability and Rehabilitation
Fouad Al-Ghamdi, Partha S Ghosh
INTRODUCTION: Neuralgic amyotrophy (NA) is characterized by the clinical triad of pain, muscle weakness/atrophy and sensory symptoms. METHODS: We retrospectively identified children (≤18 years) over 15 years (2002-2017) from a single pediatric center. RESULTS: We had 22 patients (8 female; 6-18 years); pain was the presenting manifestation in all of them. Clinical weakness involving periscapular muscles was observed in 16 patients, scapular winging in 13...
January 9, 2018: Muscle & Nerve
Paul Seror, Timothee Lenglet, Christelle Nguyen, MichaëL Ouaknine, Marie Martine Lefevre-Colau
INTRODUCTION: In this study we report a large series of patients with unilateral winged scapula (WS), with special attention to long thoracic nerve (LTN) palsy. METHODS: Clinical and electrodiagnostic data were collected from 128 patients over a 25-year period. RESULTS: Causes of unilateral WS were LTN palsy (n = 70), spinal accessory nerve (SAN) palsy (n = 39), both LTN and SAN palsy (n = 5), facioscapulohumeral dystrophy (FSH) (n = 5), orthopedic causes (n = 11), voluntary WS (n = 6), and no definite cause (n = 2)...
January 4, 2018: Muscle & Nerve
Shangming Zhang, Lucy Q Zhang, Megan Wright, David R Gater
Neuralgic amyotrophy (NA) is a neurological syndrome of unknown etiology primarily affecting the brachial plexus. We are reporting an unusual case of acute bilateral NA that was possibly secondary to Lyme disease. The patient demonstrated significant functional gains and was discharged home after 2 weeks of inpatient rehabilitation, supporting the role of inpatient rehabilitation in acute NA. In this report, we discussed the diagnosis, electrodiagnostic progression, pain management, goals for inpatient rehabilitation and overall prognosis of NA...
December 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Doris Lieba-Samal, Jeroen J J van Eijk, Marieke H J van Rosmalen, Irene M F van Balken, Aad Verrips, Jop Mostert, Sigrid Pillen, Nens van Alfen
The differential diagnosis of upper extremity mononeuritis multiplex includes neuralgic amyotrophy, vasculitic neuropathy, and Lewis-Sumner syndrome. We describe 3 patients initially suspected of neuralgic amyotrophy, who had an extremely painful, protracted, progressive disease course, not fitting one of these established diagnoses. Nerve ultrasonography showed focal caliber changes of the roots, plexus, and limb nerves. Electromyography showed predominant multifocal axonopathy. Ongoing autoimmune neuropathy was suspected...
November 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Adolfo Vigasio, Ignazio Marcoccio
BACKGROUND: Suprascapular nerve (SSN) entrapment is usually ascribed to static or dynamic compression. When no cause of compression is found, SSN entrapment is defined as idiopathic. Focal hourglass-like constriction (H-LC) of the SSN that results in muscle paralysis represents an unusual condition that may be misinterpreted and erroneously diagnosed as SSN entrapment or as neuralgic amyotrophy. METHODS: With the aim of finding clinical and surgical clues that could differentiate the traditional form of idiopathic SSN entrapment from the rare H-LC, a series of 6 cases of SSN palsy caused by H-LC is presented...
October 25, 2017: Journal of Shoulder and Elbow Surgery
Michael A Purdy, Tim J Harrison, S Jameel, X-J Meng, H Okamoto, W H M Van der Poel, Donald B Smith, Ictv Report Consortium
The family Hepeviridae includes enterically transmitted small non-enveloped positive-sense RNA viruses. It includes the genera Piscihepevirus, whose members infect fish, and Orthohepevirus, whose members infect mammals and birds. Members of the genus Orthohepevirus include hepatitis E virus, which is responsible for self-limiting acute hepatitis in humans and several mammalian species; the infection may become chronic in immunocompromised individuals. Extrahepatic manifestations of Guillain-Barré syndrome, neuralgic amyotrophy, glomerulonephritis and pancreatitis have been described in humans...
November 2017: Journal of General Virology
Alexander Katzer, Wolf-Peter Niedermauntel, Jörg Rump
Neuralgic amyotrophy of the shoulder (Parsonage-Turner syndrome) is a rare condition of unknown aetiology which manifests as acute neuropathy of the brachial plexus. Diagnosis is based on typical symptoms and physical examination. In addition, magnetic resonance imaging of the affected shoulder and the cervical spine is advisable, in order to distinguish this syndrome from other conditions with similar symptoms. There is no specific treatment for neuralgic amyotrophy, but in about 50 - 67% of cases complete recovery occurs within two to three years, depending on the severity of the symptoms when they first appear...
December 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
Montserrat Fraga, Christopher Doerig, Hervé Moulin, Florian Bihl, Felix Brunner, Beat Müllhaupt, Paolo Ripellino, David Semela, Felix Stickel, Benedetta Terziroli Beretta-Piccoli, Vincent Aubert, Amalio Telenti, Gilbert Greub, Roland Sahli, Darius Moradpour
BACKGROUND: Autochthonous hepatitis E is increasingly recognized as zoonotic infection in western countries. Serologic assays have varying sensitivity and specificity. METHODS: We implemented molecular testing to identify and characterize acute hepatitis E acquired in Switzerland. RESULTS: Ninety-three cases of mostly symptomatic acute hepatitis E acquired in Switzerland were documented by PCR between November 2011 and December 2016. Median HEV RNA was 7...
August 23, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
Jeroen J J van Eijk, Harry R Dalton, Paolo Ripellino, Richard G Madden, Catherine Jones, Miriam Fritz, Claudio Gobbi, Giorgia Melli, Emanuela Pasi, Jenny Herrod, Rebecca F Lissmann, Hamad H Ashraf, Mohamed Abdelrahim, Omar A B A L Masri, Montserrat Fraga, David Benninger, Thierry Kuntzer, Vincent Aubert, Roland Sahli, Darius Moradpour, Hélène Blasco-Perrin, Shahram Attarian, Rene Gérolami, Philippe Colson, Maria T Giordani, Johannes Hartl, Sven Pischke, Nan X Lin, Brendan N Mclean, Richard P Bendall, Marcus Panning, Jean-Marie Peron, Nassim Kamar, Jacques Izopet, Bart C Jacobs, Nens van Alfen, Baziel G M van Engelen
OBJECTIVE: To determine the clinical phenotype and outcome in hepatitis E virus-associated neuralgic amyotrophy (HEV-NA). METHODS: Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection. RESULTS: Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied...
August 29, 2017: Neurology
Harry R Dalton, Jeroen J J van Eijk, Pascal Cintas, Richie G Madden, Catherine Jones, Glynn W Webb, Benjamin Norton, Julie Pique, Suzanne Lutgens, Nikki Devooght-Johnson, Kathy Woolson, John Baker, Maria Saunders, Liz Househam, James Griffiths, Florence Abravanel, Jacques Izopet, Nassim Kamar, Nens van Alfen, Baziel G M van Engelen, Jeremy G Hunter, Annemiek A van der Eijk, Richard P Bendall, Brendan N Mclean, Bart C Jacobs
BACKGROUND & AIMS: Hepatitis E virus (HEV) has been associated with a number of neurological syndromes, but causality has not yet been established. The aim of this study was to explore the relationship between HEV and neurological illness by prospective HEV testing of patients presenting with acute non-traumatic neurological injury. METHODS: Four hundred and sixty-four consecutive patients presenting to hospital with acute non-traumatic neurological illnesses were tested for HEV by serology and PCR from four centres in the UK, France and the Netherlands...
November 2017: Journal of Hepatology
Rocio Garcia-Santibanez, Craig M Zaidman, Tonya Russell, Robert C Bucelli
No abstract text is available yet for this article.
July 19, 2017: Muscle & Nerve
Anna Herbert, Waseem Asrar Khan, Salem Madi
A 45-year-old man with a raised body mass index presented with an acute history of right lower chest pain and increasing breathlessness. C reactive protein, D dimer and cardiac echocardiography were negative, with mild bibasal atelectasis the only positive reported finding from erect chest X-ray and CT pulmonary angiogram. He was discharged with antibiotics for a chest infection. He remained severely breathless and was referred to the sleep-related breathing disorders clinic. He described shoulder pain, daytime tiredness and sleeping upright due to a ââ'¬Ëœsuffocatingââ'¬â"¢ sensation...
July 18, 2017: BMJ Case Reports
Brenda L Rice, Rendell W Ashton, Xiao-Feng Wang, Steven J Shook, Eduardo Mireles-Cabodevila, Loutfi S Aboussouan
BACKGROUND: Neuralgic amyotrophy is an inflammatory peripheral nerve disorder in which phrenic nerve involvement can lead to diaphragm paralysis. The prevalence, magnitude, and time course of diaphragm recovery are uncertain. METHODS: This study modeled the course of recovery of lung function in 16 subjects with diaphragm impairment from neuralgic amyotrophy. The first and last available vital capacity, sitting-to-supine decline in vital capacity, and maximal inspiratory pressures were compared...
October 2017: Respiratory Care
Joseph M Neal, Susan S Porter, Barry P Wilson
OBJECTIVE: We report a case of misdiagnosed neuralgic amyotrophy (brachial plexus neuritis, Parsonage-Turner syndrome). Our primary objective is to review the scientific basis for errors in clinical reasoning. CASE REPORT: We herein report a patient in whom signs and symptoms compatible with neuralgic amyotrophy presented after shoulder surgery. The patient's brachial plexopathy was attributed incorrectly as a complication of interscalene brachial plexus block. The true diagnosis was made only after the patient developed neuralgic amyotrophy in the contralateral upper extremity after a subsequent shoulder surgery on that side, this time without a brachial plexus block...
September 2017: Regional Anesthesia and Pain Medicine
A Brys, A Wijers, M de Vries, N Bouwman, R Borghans
BACKGROUND: Neuralgic amyotrophy is characterised by pain in the neck or shoulder region, followed by neuropathy of both motor and sensory nerves of the brachial plexus. The incidence of this condition is estimated at 1/1000 per year. In a rare variant of the syndrome, involvement of both phrenic nerves can occur, leading to diaphragmatic paralysis and severe orthopnoea. CASE DESCRIPTION: A 67-year-old woman was referred to us with acute orthopnoea. Imaging studies showed bilateral diaphragmatic paralysis, and electromyography (EMG) confirmed neuropathy of both phrenic nerves...
2017: Nederlands Tijdschrift Voor Geneeskunde
Brendan N Mclean, James Gulliver, Harry R Dalton
Hepatitis E is the most common cause of hepatitis worldwide. While originally considered a disease of developing countries, it is increasingly recognised in developed countries, probably related to contaminated pork meat, and where infection is often asymptomatic. However, several non-liver manifestations have become apparent, the most important of which are neurological, including Guillain-Barré syndrome (acute inflammatory demyelinating polyradiculoneuropathy (AIDP)), neuralgic amyotrophy and meningoencephalitis...
August 2017: Practical Neurology
Nens Van Alfen
No abstract text is available yet for this article.
June 23, 2017: Muscle & Nerve
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