Neuralgic amyotrophy: a long term follow-up of four cases.
(26/52)
Neuralgic amyotrophy or brachial plexus neuralgia is a condition of uncertain etiology. It needs to be differentiated from the usual brachial plexus injuries. Nerves outside the plexus especially the spinal accessory nerve are involved. Neuralgia is also a feature. Four cases were followed-up in detail over a period of two years. The condition usually resolves almost completely on its own. (+info)
Magnetic and electrical stimulation of cervical motor roots: technique, site and mechanisms of excitation.
(27/52)
Cervical motor roots and the brachial plexus were excited transcutaneously with magnetic (MagStim) and electrical stimulation (ElStim) applied dorsally over the spine and over the supraclavicular fossa (Erb's point). The compound muscle action potentials (CMAPs) from the abductor digiti minimi (ADM) and the biceps muscles (BICEPS) could be evoked with either stimulating technique in all 52 subjects tested. With MagStim over the spinous process C7, greater CMAPs were obtained from ADM (p less than or equal to 0.0001, paired t test) and BICEPS (p less than or equal to 0.005) when the inducing current in the coil as viewed from behind was clockwise for the right arm and vice versa. ElStim with the cathode over C7/T1 and the anode directed cranially provided greater CMAPs from the ADM (p less than or equal to 0.0001) and smaller CMAPs from the BICEPS (p less than or equal to 0.01) than with the inverse polarity. MagStim of the cervical roots provided CMAPs which were smaller from ADM (p less than or equal to 0.0001), and greater from BICEPS (p less than or equal to 0.0001), than ElStim (cathode C7/T1), whereas latencies did not differ significantly (p less than or equal to 0.3). When comparing ElStim and MagStim applied over Erb's point, the former yielded greater CMAPs and 0.5 ms longer latencies from both the ADM and BICEPS (p less than or equal to 0.001). From these data and additional studies in four patients, including direct intraoperative root stimulation in one of them, it is concluded that ElStim and MagStim over the spine excite the motor roots at a similar site, that is, within a few cm outside the intervertebral foramina. The site of stimulation is difficult to predict and depends on the placement of the stimulating devices and the intensities used. In contrast, MagStim of the brachial plexus over Erb's point occurs on average about 3.5 cm distal to the site of ElmStim. (+info)
Neuralgic amyotrophy associated with dengue fever: case series of three patients.
(28/52)
Intravenous immunoglobulin (IVIg) with methylprednisolone pulse therapy for motor impairment of neuralgic amyotrophy: clinical observations in 10 cases.
(29/52)
BACKGROUND: Neuralgic amyotrophy (NA) is a distinct peripheral nervous system disorder characterized by attacks of acute neuropathic pain and rapid multifocal weakness and atrophy unilaterally in the upper limb. The current hypothesis is that the episodes are caused by an immune-mediated response to the brachial plexus, however, therapeutic strategies for NA have not been well established. METHODS AND RESULTS: We retrospectively reviewed 15 case series of NA; 10 of the 15 patients received intravenous immunoglobulin (IVIg) with methylprednisolone pulse therapy (MPPT) and 9 of these 0 patients showed clinical improvement of motor impairment. CONCLUSION: Our clinical observations do not contradict the possibility that IVIg with MPPT may be one of the potential therapeutics for NA, however the efficacy remains to be established. Further confirmatory trials are needed in patients with various clinical severities and phases of NA. Further basic research and confirmatory trials should be performed to survey the efficacy of such immunomodulation therapy for NA. (+info)
Isolated shoulder palsy due to infarction of the cortical branch of the middle cerebral artery.
(30/52)
A 71-year-old man with hyperlipidemia abruptly developed left-sided isolated shoulder palsy. Cranial magnetic resonance imaging demonstrated infarction of the cortical branch of the right middle cerebral artery (MCA). In the primary motor cortex, there is broad somatotopic representation of various body parts in a particular arrangement, and the area corresponding to the shoulder is very small. Consequently, there have been only 3 reported cases of isolated shoulder palsy due to cerebral infarction, and its vascular supply remains uncertain. The present case indicates that the corresponding area to the shoulder receives its blood from the cortical branch of the MCA. (+info)
Surgical and postpartum hereditary brachial plexus attacks and prophylactic immunotherapy.
(31/52)
A case of cervico-brachial disorder due to tactile interpretation for deaf-blind persons.
(32/52)
OBJECTIVES: We herein report a case of cervico-brachial disorder (CBD) due to long-term tactile interpreting. METHODS: The patient was interviewed to investigate her past history, occupational history, work conditions and clinical course in detail. The case was diagnosed in accordance with the "Diagnostic Criteria for CBD 2007" established by the Research Association for CBD of the Japanese Society for Occupational Health. RESULTS: The patient was a 49-year-old female who has worked as a regular occupational instructor at a welfare work activity center for deaf people since April 22, 2010. Her primary job is to instruct and aid others in learning confectionery manufacturing and coffee shop tasks. She also performs tactile interpreting for two deaf-blind workers during a morning health check and during any meetings. On September 3, 2010, she interpreted by tactile signing for about three hours alone during a meeting, due to the absence of other interpreters. She developed severe pain in her back immediately after carrying out this interpretation, and the pain thereafter continued and developed in the upper extremities. She was diagnosed with a severe and prolonged case of the non-specific type of CBD. DISCUSSION: Interpretation by tactile signing may impose a heavier burden on the upper extremities, shoulders and neck than that imposed by common sign language. A shorter time of interpretation, ensuring the availability of rest time and supporting tools or methods for the upper extremities, are therefore considered to be necessary to prevent the incidence of CBD among interpreters using tactile signing. (+info)