Clinical features and MRI characteristics in neuralgic amyotrophy
神経痛性筋萎縮症(neuralgic amyotrophy)の臨床像とMRI所見

Kazuhiro Fukushima
2014 Rinsho Shinkeigaku  
54:1053 神経痛性筋萎縮症 (neuralgic amyotrophy; NA) は,Parsonage-Turner syndrome,あるいは Idiopathic brachial plexopathy とも 呼ばれる症候群である.病変部位については諸説あるが,腕 神経叢とその近傍を主座とする特発性の末梢神経障害と考え るのが一般的である 1) 2) .腕神経叢は,肩関節運動にともなう 可動性という特徴から機械的ストレスを受けやすい部位であ り,労作や過度のスポーツ,外傷などにより blood-nerve 10) Moriguchi K, Miyamoto K, Takada K, et al. Four cases of anti-ganglioside antibody-positive neuralgic amyotrophy with good response to intravenous immunoglobulin infusion therapy. Neuralgic amyotrophy (NA) is a distinct peripheral
more » ... inct peripheral nervous system (PNS) disorder characterised by sudden attacks of neuropathic pain, usually in a unilateral upper extremity, and patchy paresis with amyotrophy. Under-recognition of NA patients may be frequent because symptoms of NA can be similar to those of common orthopedic disorders. The lesion sites of NA are commonly considered to be brachial plexus (BP) and/or individual branches of the BP. The cause of NA remains unknown. Some evidence support the concept of a complex pathogenesis in NA that includes underlying predisposition and susceptible PNS structures, and it can be triggered by infection, trauma, and strenuous exercise. Typical presentation of NA is characterized by patchy paresis of the periscapular and periglenohumeral muscles. In such cases, STIR-MRI often shows hyperintense signal abnormalities on the affected side of the proximal upper BP. NA is considered to be broad and encompasses a spectrum of atypical presentations, including involvement of lower part of BP, isolated nerves (anterior interosseous nerve or posterior interosseous nerve), or lumbosacral plexuses. Functional prognosis of NA is less favorable than previously assumed. Administration of corticosteroids and intravenous immunoglobulin was described as potential therapeutics for NA, although their efficacy remains unestablished. (Clin Neurol 2014;54:1053-1055
doi:10.5692/clinicalneurol.54.1053 pmid:25672707 fatcat:tz72uhrjxzh3pc264rlp5ajzmm