Brachial Neuritis or Neuralgic Amyotrophy

Brachial Neuritis or Neuralgic Amyotrophy is a medical condition in which there is inflammation of the nerves of the upper extremities, especially the hands, arm, and shoulders. The nerves of the shoulders, arms, and hands form a network called as the brachial plexus, which runs from the spinal cord to the shoulder and the arm. Brachial Neuritis or Neuralgic Amyotrophy can result in excruciating and unrelenting pain in the shoulders and when the pain goes away there will be extreme weakness of the shoulders and arms and you will find it difficult to move your arms fluently. Brachial Neuritis or Neuralgic Amyotrophy is a rare disease and usually starts out of the blue normally at night. Brachial Neuritis is also known by the name of Parsonage Turner Syndrome. There are two forms of Brachial Neuritis or Neuralgic Amyotrophy. One is the idiopathic form, which is usually found in people with a compromised immune system and the other one is the inherited form in which the person is born with this condition. In either case why this condition develops is still a matter of ongoing research.

The exact cause of Brachial Neuritis or Neuralgic Amyotrophy is still unknown, but it is seen that this condition is more common in males. This condition can be found in people of all ages, but usually is found between the age of 20 and 60. Some of the conditions where Brachial Neuritis or Neuralgic Amyotrophy is known to occur are as follows:

• Recent bacterial or viral infection
• If you have had a recent bout of Systemic Lupus Erythematosus
• It is also seen to occur after vaccinations
• Brachial Neuritis or Neuralgic Amyotrophy may also be caused due to an injury to the nerves
• Brachial Neuritis or Neuralgic Amyotrophy can also be an after effect of a surgical procedure
• Lumbar punctures have also been shown to cause Brachial Neuritis or Neuralgic Amyotrophy
• Females are vulnerable to get Brachial Neuritis or Neuralgic Amyotrophy while they are in the process of giving birth to a child.

The symptoms caused by Brachial Neuritis or Neuralgic Amyotrophy is different with each attack and may vary from person to person, but more often than not this condition starts off with pain which then progresses to extreme weakness once the pain calms down. Some of the other symptoms that can be experienced are:

• Severe pain in the shoulder usually at night, generally in the right shoulder but may happen in both shoulders.
• The pain will be described as stinging and stabbing in characteristic
• The Brachial Neuritis pain becomes worse with movement
• The pain will be constant and may last for as less than a few hours to as many as a few days
• Once the pain starts to subside there will extreme weakness of the shoulders
• Muscle wasting
• Numbness of the shoulders is a common symptoms in Brachial Neuritis or Neuralgic Amyotrophy.

To begin with, the treating physician will conduct a detailed history taking in which the physician will ask as to when the symptoms started, whether there have been episodes like this before, is anyone else in family having the same condition, is there any history of an injury to the shoulders in the recent past. The physician will then conduct a physical examination in which he or she will palpate the affected arm to look for signs of tenderness or muscle wasting. The physician will also check the range of motion of the shoulders and see if any movement of the shoulder causes pain. In some cases, a reflex examination will also be conducted to see if the reflexes are normal. Apart from this, blood draws will be conducted to look for any underlying infections causing nerve inflammation. Radiologic studies in the form of x-rays, MRI, or CT scan may be ordered to look at the internal structures of the shoulders and see if there is any abnormality like a tumor or a herniation that may be compressing the nerves. An EMG study will be conducted to see the status of the nerves and whether they are functioning normally.

Conservative Treatment For Brachial Neuritis or Neuralgic Amyotrophy: Initially, the patient will be treated using a conservative approach by strong pain killers for pain relief. The patient will also be given certain exercises to do to increase their range of motion and strengthen the shoulders once the pain has resolved to an extent. In order to make the shoulders strong, the patient will be prescribed a series of active and passive stretches for the shoulder which he or she will have to do regularly to get the strength back of the shoulder. This exercises program will have to be done for at least a time frame of six to eight weeks. For this, the patient will be referred to a physical therapist who will formulate a therapy program relevant to the patient.

Surgical Approach To Treat Brachial Neuritis or Neuralgic Amyotrophy: In extremely rare cases where symptoms of Brachial Neuritis or Neuralgic Amyotrophy do not improve with conservative approach then the physician will recommend surgery to correct the problem. This is only done after failure to improve for a period of more than two years. The surgical procedure will involve correcting the injured nerves such that they start to function normally.

The pain caused due to Brachial Neuritis or Neuralgic Amyotrophy usually lasts for a few weeks and the muscle weakness resolves within a few months. It is seen that the more the pain takes to calm down the more time it takes for a person to recover completely from a bout of Brachial Neuritis or Neuralgic Amyotrophy. In case if an individual does not regain full strength even after the pain resolves after a few months then the individual will have to consult a therapist to formulate an exercise program for strengthening the shoulder and get it back to normal after the bout of Brachial Neuritis or Neuralgic Amyotrophy.