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Brachial Neuritis


- See: Parsonage-Turner Syndrome:

- Discussion:
    - characterized by acute or subacute onset of severe pain in neck, arm, & hand along w/ varialble muscle weakness & loss in sensation;
    - pain is usually severe and constant and aggravated by moving the arm;
    - diff dx: neuropathic disorder
    - clinical coarse:
           - recovery occurs over a period of several weeks or months;
           - treatment involves complete rest of the arm and analgesics;

- Exam: of Brachial Plexus:
    - neuro exam of the brachial plexus:
    - in brachial neuritis, motor changes will predominate over sensory changes;
    - there may be variable weakness from C5 to T1;

- Studies:
    - CXR: (elevated hemidiaphram)
    - C-Spine X-ray:
    - EMG:
           - perform at 3-4 weeks (look for F wave)
           - w/ preganglionic lesion, see denervating potentials in segmental paraspinal muscles innervated by the posterior primary rami;
           - ref: Clinical Diagnosis, Testing, and Electromyographic Study in Brachial Plexus Traction Injuries;

- Initial Treatment:
      - avoid a sling because of the propensity to acquire a fixed internally rotated and flexed shoulder, and will have stiff elbow



Brachial Neuritis.