Neuralgic amyotrophy: An update in evaluation, diagnosis, and treatment approaches.

Autor: Gabet JM; Department of Physical Medicine and Rehabilitation, MetroHealth Rehabilitation Institute, The MetroHealth System and Case Western Reserve University, Cleveland, Ohio, USA., Anderson N; Department of Neurology, University of California San Francisco Medical Center and Weill Institute for Neurosciences, San Francisco, California, USA., Groothuis JT; Department of Rehabilitation, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands., Zeldin ER; Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA., Norbury JW; Department of Neurology, Division of Physical Medicine and Rehabilitation, Texas Tech Health Sciences Center, Lubbock, Texas, USA., Jack AS; Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada., Jacques L; Department of Neurological Surgery, University of California San Francisco Medical Center and Weill Institute for Neurosciences, San Francisco, California, USA., Sneag DB; Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA., Poncelet A; Department of Neurology, University of California San Francisco Medical Center and Weill Institute for Neurosciences, San Francisco, California, USA.
Jazyk: angličtina
Zdroj: Muscle & nerve [Muscle Nerve] 2024 Oct 14. Date of Electronic Publication: 2024 Oct 14.
DOI: 10.1002/mus.28274
Abstrakt: Neuralgic amyotrophy (NA) is an underrecognized peripheral nerve disorder distinguished by severe pain followed by weakness in the distribution of one or more nerves, most commonly in the upper extremity. While classically felt to carry a favorable prognosis, updates in research have demonstrated that patients frequently endure delay in diagnosis and continue to experience long term pain, paresis, and fatigue even years after the diagnosis is made. A transition in therapeutic approach is recommended and described by this review, which emphasizes the necessity to target compensatory abnormal motor control and fatigue by focusing on motor coordination, energy conservation strategies, and behavioral change, rather than strength training which may worsen the symptoms. The development of structural hourglass-like constrictions (HGCs) on imaging can help confirm the suspected clinical diagnosis, and in association with persistent weakness and limited recovery on electrodiagnostic testing may be considered for surgical consultation. Given the complex nature of management, a multidisciplinary approach is described, which can provide an optimal level of care and support for patients with persistent symptoms from NA and allow more unified guidance of rehabilitation and surgical referrals.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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