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Acute brachial neuritis

Introduction

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Synonyms and keywords: Parsonage Turner syndrome; brachial plexopathy; brachial plexus dysfunction

Overview

Overview

Acute brachial neuritis (also known as Parsonage-Turner syndrome) is a rare syndrome of unknown etiology affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. Acute brachial neuritis usually is characterized by the acute onset of excruciating unilateral shoulder pain, followed by flaccid paralysis of shoulder and parascapular muscles after several days.

Historical Perspective

  • [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
  • In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
  • In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

  • [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]
  • Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

  • The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
  • The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
  • On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
  • On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Causes

Acute brachial neuritis is a form of peripheral neuropathy. It occurs when there is damage to the brachial plexus, an area where a nerve bundle from the spinal cord splits into the individual arm nerves.

Differentiating [disease name] from other Diseases

  • [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Epidemiology and Demographics

In the USA each year, there are approximately 1 to 2 cases per 100,000 people. The reported incidence in the UK is 3 cases per 100,000 people.

Natural History, Complications and Prognosis

The likely outcome depends on the cause. A good recovery is possible if the cause is identified and properly treatment. In some cases, there may be a partial or complete loss of movement or sensation. Nerve pain may be severe and may persist for a long time.

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10Β­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • There are no [imaging study] findings associated with [disease name].
  • [Imaging study 1] is the imaging modality of choice for [disease name].
  • On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
  • [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

Surgery

Some patients with brachial plexopathy may benefit from surgery if nerve compression is the cause of the symptoms.

Prevention

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Historical Perspective

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Overview

Historical Perspective

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Classification

Overview

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Classification

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pathophysiology

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Overview

Pathophysiology

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Causes

Overview

Acute brachial neuritis is a form of peripheral neuropathy. It occurs when there is damage to the brachial plexus, an area where a nerve bundle from the spinal cord splits into the individual arm nerves.

Causes

Damage to the brachial plexus is usually related to direct injury to the nerve, stretching injuries (including birth trauma), pressure from tumors in the area, or damage that results from radiation therapy.

Acute brachial neuritis may also be associated with:

  • Birth defects (that put pressure on the neck area).
  • Exposure to toxins, chemicals, or drugs.
  • Inflammatory conditions, such as those due to a virus or immune system problem.
  • In some cases, it is idiopathic.

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Acute brachial neuritis from other Diseases

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Overview

Differential Diagnosis

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Epidemiology and Demographics

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Overview

In the USA each year, there are approximately 1 to 2 cases per 100,000 people. The reported incidence in the UK is 3 cases per 100,000 people.

Epidemiology and Demographics

Age

Young to middle-aged adults are most commonly affected, although the condition can occur at any age .

Gender

Males are 2 to 4 times more likely to have this medical condition than females. Though there are exceptions when compared with the inherited form, which affects males and females equally.

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Risk Factors

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Overview

Risk Factors

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Screening

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Overview

Screening

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Natural History, Complications and Prognosis

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Overview

The likely outcome depends on the cause. A good recovery is possible if the cause is identified and properly treatment. In some cases, there may be a partial or complete loss of movement or sensation. Nerve pain may be severe and may persist for a long time.

Natural History

Complications

  • Deformity of the hand or arm, mild to severe, which can lead to contractures
  • Partial or complete arm paralysis
  • Partial or complete loss of sensation in the arm, hand, or fingers
  • Recurrent or unnoticed injury to the hand or arm due to diminished sensation

Prognosis

The likely outcome depends on the cause. A good recovery is possible if the cause is identified and properly treatment.

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Diagnosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electromyogram | X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Overview

Tests that may be done to diagnose this condition may include:

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Treatment

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case Studies

Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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