Volume 29, Issue 1 , Pages 52-59, January 2006
Idiopathic Neuralgic Amyotrophy: An Illustrative Case Report
Abstract
Objective
To describe the case of a patient diagnosed with neuralgic amyotrophy (NA) illustrating pertinent aspects of differential diagnosis, the use of clinical neurophysiological procedures to aid in establishing the diagnosis, and issues of management.
Clinical Features
A 39-year-old male soldier presented with a rapid onset of marked loss of left shoulder movement. This started acutely early one morning as a sharp, severe lower neck pain progressing over the following 2 weeks to a less severe dull ache in the left shoulder and arm. Pain was rapidly replaced with weakness. Physical examination and electrodiagnostic investigation helped establish a diagnosis of NA.
Intervention and Outcome
The patient was reassured that this is normally a self-limiting condition. Range of motion exercises progressing to a strengthening program was prescribed. He was progressing well; however, we lost contact because of his commitments in the armed service.
Conclusion
When a patient presents with shoulder and arm pain of neurogenic origin, NA should be a consideration. Differentiating NA from radiculopathy is especially important in making management decisions. With a careful history and physical examination, the diagnosis may be made without the need for ancillary investigations. Neuralgic amyotrophy is a self-limiting condition requiring reassurance and monitoring.
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Sources of support: No external funds were provided for this research.
PII: S0161-4754(05)00350-7
doi:10.1016/j.jmpt.2005.11.008
© 2006 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
Volume 29, Issue 1 , Pages 52-59, January 2006
