• Title/Summary/Keyword: brachial plexus

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Neuralgic Amyotrophy Manifesting as Mimicking Posterior Interosseous Nerve Palsy

  • Yang, Jin Seo;Cho, Yong Jun;Kang, Suk Hyung;Choi, Eun Hi
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.491-493
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    • 2015
  • The upper trunk of the brachial plexus is the most common area affected by neuralgic amyotrophy (NA), and paresis of the shoulder girdle muscle is the most prevalent manifestation. Posterior interosseous nerve palsy is a rare presentation in patients with NA. It results in dropped finger on the affected side and may be misdiagnosed as entrapment syndrome or compressive neuropathy. We report an unusual case of NA manifested as PIN palsy and suggest that knowledge of clinical NA phenotypes is crucial for early diagnosis of peripheral nerve palsies.

Exacerbation of spasticity in ipsilateral shoulder after right brachial plexus block in a patient with right hemiplegia

  • Park, Sang-Jin;Baek, Jong-Yoon
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.22-25
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    • 2015
  • Spasticity is a common impairment in patients with central nervous system disease. Clinical observation has demonstrated that spasticity can be aggravated by various factors such as emotional state as well as noxious stimuli. A 51-year-old male patient was scheduled for arteriovenous fistula surgery. He had right hemiplegia including motor weakness and spasticity. It was decided that the surgery would be performed under an axillary brachial plexus block (BPB). He appeared nervous when blockade was terminated. The spasticity of the right shoulder increased after ipsilateral BPB. However, when we administered sedative drugs and performed interscalene BPB 2 days later, spasticity did not occur. Exacerbation of spasticity might be evoked by an anxious emotional state. Thus, it seems to be good to consider removing of anxiety and using an appropriate approach when it is tried to perform nerve blocks in individuals with spasticity.

Reflex Sympathetic Dystrophy following Carbon Monoxide Intoxication (일산화탄소 중독후에 발생한 반사성 교감신경성 위축증)

  • Han, Young-Jin;Choe, Huhn
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.261-264
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    • 1993
  • A 26 year old male patient had admitted to the department of plastic surgery for the treatment of skin defect of forearm and spastic contracture of right hand, attributable to burn injury following carbon monoxide intoxication. After receiving skin graft the patients tenotomy of flexor tendons, the patients was consulted to pain clinic for further evaluation and treatment of allodynia, hyperalgesia, and hyperpathia with marked emotional insufficiency. The patient was treated with stellate ganglion blocks, intermittent or continuous epidural blocks, and intermittent brachial plexus blocks for 3 months. with this treatment the patient's pain level improved to(VAS 10 to 4~5) and was discharged. The patient was readmitted 3 months later, due to the aggrzvation of pain. Brachial plexus blocks were given again by interscalene, supraclavicular, or axillary route, sometimes using a catheter, together with cervical epidural blocks. Tricyclic antidepressant was also prescribed. The results were remarkably good(VAS 2~3) and the patient did not require any further analgesic medication.

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Neuralgia Amyotrophy Induced by Herpes Zoster (대상포진에 의해 발현된 근위축성 신경통)

  • Kim, Byung Jo;Koh, Seong Beom;Park, Min Kyu;Park, Kun Woo;Lee, Dae Hie
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.164-167
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    • 2001
  • The etiology of neuralgia amyotrophy remains unclear. Herpes zoster induced neuralgia amyotrophy has been reported in extremely rare cases. In this case report, we describe the clinical features and electrophysiologic findings in a 68-year-old patient with neuralgia amyotrophy associated with herpes zoster infection. We suggest that brachial plexus inflammation due to viral infection may be a direct cause of reversible neuralgia amyotrophy.

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The Value of MRI in Diagnosis of Peripheral Nerve Disorders (말초신경질환에서 자기공명영상의 진단적 가치)

  • Lee, Han Young;Lee, Jang Chull;Kim, Il-Man;Lee, Chang-Young;Ikm, Eun;Kim, Dong Won;Yim, Man Bin
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1120-1126
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    • 2001
  • Objective : The development of magnetic resonance neurography(MRN) has made it possible to produce highresolution images of peripheral nerves themselves, as well as associated intraneural and extraneural lesions. We evaluated the clinical application and utility of high-resolution MRN techniques for the diagnosis and treatment of a variety of peripheral nerve disorder(PND)s. Material and Method : MRN images were obtained using T1-weighted spin echo, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery(STIR) fast spin-echo pulse sequences. Fifteen patients were studied, three with brachial plexus tumors, five with chronic entrapment syndromes, and seven with traumatic peripheral lesions. Ten patients underwent surgery. Results : In MRN with STIR sequences of axial and coronal imagings, signals of the peripheral nerves with various lesions were detected as fairly bright signals and were discerned from signals of the uninvolved nerves. Increased signal with proximal swelling and distal flattening of the median nerve were seen in all patients of carpal tunnel syndrome. Among the eight patients with brachial plexus injury or tumors, T2-weighted MRN showed increased signal intensity in involved roots in five, enhanced mass lesions in three, and traumatic pseudomeningocele in three. Other associated MRI findings were adjacent bony signal change, neuroma, root adhesion and denervated muscle atophy with signal change. Conclusion : MRN with high-resolution imaging can be useful in the preoperative evaluation and surgical planning in patients with peripheral nerve lesions.

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Neuroradiologic and Neurophysiologic Findings of Neuralgic Amyotrophy

  • Yu, Dong-Kun;Cho, Yong-Jun;Heo, Dong-Hwa;Hong, Myung-Sun;Park, Se-Hyuck
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.423-428
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    • 2010
  • Objective : Neuralgic amyotrophy (NA) is a distinct clinical syndrome that is characterized by the acute onset of shoulder and arm pain, weakness, and sensory loss. The purpose of this study was to assess the clinical characteristics of NA and to determine appropriate diagnostic modalities. Methods : We reviewed the medical and radiologic records of 10 patients diagnosed with NA retrospectively. Neurophysiologic studies were performed in all patients and magnetic resonance neurography was performed in the last three patients. Results : A total of 10 patients were enrolled in our study. All patients had clinical findings compatible with NA. The most common clinical presentation was severe shoulder pain and weakness in seven patients (70%). Neurophysiologic study results were abnormal in all patients. Brachial plexus magnetic resonance neurography showed that the affected brachial plexus showed a thickened and hyper-intense trunk. All patients were managed conservatively with analgesics and physical therapy. The pain and paralysis of all patients improved clinically within 6 months of the initiation of treatment. Conclusion : NA is a rare disease but the symptoms of NA can mimic those of other diseases. Neurophysiologic studies and magnetic resonance neurography are extremely useful tools for the diagnosis of NA.

En Bloc Resection of a Thoracic Outlet for a Recurred Malignant Schwannoma of the Brachial Plexus - A case report - (상완신경총에 재발한 악성 신경초종에 대한 흉곽출구의 광범위 구역절제술 치험 - 1예 보고 -)

  • Kim, Young-Kyu;Park, Chin-Su;Son, Bong-Su;Kim, Yeong-Dae
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.715-718
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    • 2007
  • Neurogenic tumors of the brachial plexus are rare. An malignant schwannoma originates from the schwan cells or nerve sheath cells. Occasionally, schwannomas are associated with Von Rechlinghausen's disease, but this is rare. We were recently presented with a thirty-five year old female patient with a history of pulmonary tuberculosis about ten years prior. The patient also presented with a mass that has been slowly growing for one year. Onset of pain occurred six months after the tumor began to grow. The mass was $5{\times}7cm$ in size. The patient underwent on bloc resection of the tumor as the mass recurred twice in spite of postoperative radiotherapy.

Treatment of Traumatic Brachial Plexus Injury with Traditional Korean Medicine Focusing on Warm Needling and Bee Venom Injection: A Case Report (외상성 상완신경총 손상에 대해 온침요법과 봉독약침요법을 중심으로 한방복합치료를 적용한 치험 1례 증례보고)

  • Jo, Dae Hyun;Kwon, Min Soo;Kim, Jung Hwan;Choi, Ji Eun;Han, Ji Sun;Nam, Dong Woo;Choi, Do Young;Lee, Jae Dong
    • Journal of Acupuncture Research
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    • v.32 no.2
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    • pp.229-240
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    • 2015
  • Objectives : The purpose of this report is to show the effect of complex traditional Korean medical care focused on warm needling(WN) and bee venom(BV) injection for a patient suffering from traumatic brachial plexus injury(BPI). Methods : A 51-year-old female patient with BPI was suffering from paresis and hypoesthesia with upper-extremity impairment. The patient had been treated once a day from 4 Feb to 11 Apr of 2015 mainly with WN and BV injection on the acupoints near the distribution of the brachial plexus. Improvement of the symptoms was measured by range of motion(ROM), manual muscle test(MMT) grip strength, and with the numeric rating scale(NRS) of tactile and pain sensitivity. Results : After 67 days of treatment, all obtained results showed remarkable improvement. The patient's satisfaction declaration was recorded through an interview at the end of the treatment. Conclusions : The results suggest that anatomically concerned WN and BV treatment can be a valuable option in reducing or normalizing pains from traumatic BPI.