Abstract
Introduction
Acute brachial plexus neuropathy is characterized by acute onset of shoulder girdle
and arm pain, followed by weakness of the shoulder and arm muscles. It affects primarily
nerves of the upper trunk of the brachial plexus and the long thoracic nerve. Cranial
nerve involvement is an infrequent association and implies a diagnostic challenge.
We report a unique case of acute brachial plexus neuropathy with involvement of the
cranial nerves IX, X, XI and XII.
Case report
Fifty six year-old woman who developed acute dysphonia, dysphagia and left shoulder
pain, followed, six days later, by left arm weakness. Needle examination showed only
fibrillation potentials and positive sharp waves in the left deltoid muscle. MRI of
the brachial plexus shows enlargement of the trunks, cords and terminal branches,
with mild gadolinium enhancement.
Discussion
This case illustrates the unique presentation of neuralgic amyotrophy with involvement
of nerves outside the brachial plexus, and the importance of MRI for diagnosis, in
the absence of electrophysiologic involvement.
Keywords
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Article info
Publication history
Published online: August 16, 2013
Accepted:
July 22,
2013
Received in revised form:
June 25,
2013
Received:
May 25,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
