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Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment
Author(s) -
Van Eijk Jeroen J.J.,
Groothuis Jan T.,
Van Alfen Nens
Publication year - 2016
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25008
Subject(s) - medicine , etiology , epidemiology , intensive care medicine , differential diagnosis , pathophysiology , amyotrophy , incidence (geometry) , clinical trial , bioinformatics , pathology , atrophy , physics , optics , biology
In this review we provide a current overview of the clinical features, pathophysiology, epidemiology, and diagnostic and therapeutic strategies in neuralgic amyotrophy (NA). The disorder has several phenotypic variations, with a classic form in 70% of the patients. It is not rare, with an incidence of 1 per 1,000 individuals, but it is still often missed. Recurrences are common, yet the proposed multifactorial etiology, which includes genetic, biomechanical, and immunologic factors, limits our capacity to predict or prevent them. NA is a clinical diagnosis, and ancillary studies serve to exclude infectious or malignant causes or to assess a differential diagnosis. If patients are seen early and are still in pain, a short trial of high‐dose oral corticosteroids is advised, and adequate analgesia may require opioids and non‐steroidal anti‐inflammatory drugs. Persistent complaints are common, and a multidisciplinary rehabilitation approach focusing on scapular coordination, energy distribution strategies, and self‐management is indicated. Muscle Nerve 53: 337–350, 2016