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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Viral invasion of the motoneurons and the subsequent inflammation in the anterior horn cells by the varicella zoster virus results in a weakness in the area of the cutaneous eruption. The exact mechanism of zoster paresis is uncertain. The occurrence of symptoms resembling complex regional pain syndrome (CRPS) is common in subjects where the herpes zoster (HZ) outbreak affects an extremity, particularly if it is the distal extremity that is involved. We report the case of a 54-year-old man with monoparesis, hyperalgesia, allodynia, edema, and both color and skin-temperature changes in his left arm after a skin eruption. Electrophysiologic examination revealed the partial degeneration of the superior, middle, and inferior truncus in the brachial plexus, with evidence of HZ infection. Magnetic resonance imaging of the cervical spine and brachial plexus showed degenerative changes without any evidence of nerve root compression. Brachial plexopathy may be the direct cause of the reversible upper-limb paresis resulting from HZ with CRPS-like symptoms.
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PMID:Monoparesis with complex regional pain syndrome-like symptoms due to brachial plexopathy caused by the varicella zoster virus: a case report. 1714 48

Entrapment of the suprascapular nerve is a rare peripheral neuropathy, which can be easily overlooked in the differential diagnosis of shoulder pain and dysfunction. Entrapment of the suprascapular nerve can occur at different locations along the pathway of the nerve. The primary symptoms are pain, weakness, and atrophy of the supraspinate and infraspinate muscles. Differential diagnosis should include brachial plexopathy, disorders of the cervical spine, cervical discopathy, glenohumeral pathology, tendonitis, and rotator cuff tear. Accurate diagnosis facilitates appropriate and timely treatment.
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PMID:Entrapment of the suprascapular nerve: anatomy, etiology, diagnosis, treatment. 1751 77

An unusual case of brachial plexopathy following an alcohol binge is presented. The patient developed numbness and weakness of his right hand and neurophysiological tests demonstrated that the lesion level was at the brachial plexus. MRI of the brachial plexus, cerebrospinal fluid examination and DNA analysis for hereditary neuropathy with liability to pressure palsies were normal. Repeated neurological examination and neurophysiological studies 60 days later were normal. A diagnosis of brachial plexus neuropathy consequent to non-traumatic stretching of the middle and the lower trunks was made.
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PMID:Saturday night brachial plexus palsy. 1797 44

A 55-year-old Indian woman with newly-diagnosed diabetes mellitus presented with acute onset right upper limb proximal weakness. This was followed three weeks later by pain, weakness and sensory loss in the left upper limb. Electrodiagnosis showed patchy multiple proximal and distal axonal neuropathies in both upper limbs, consistent with bilateral brachial neuritis. Laboratory investigations, cerebrospinal fluid analysis, and imaging studies were normal except for an antinuclear antibody titre of 1:640. Sural nerve and quadriceps biopsy did not show vasculitis. Brachial plexopathy has seldom been associated with diabetes mellitus and could represent a rare subtype of the diabetic neuropathies.
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PMID:Bilateral brachial plexopathy as an initial presentation in a newly-diagnosed, uncontrolled case of diabetes mellitus. 1830 21

Radiation myelopathy (RM) is a relatively rare disorder characterized by white matter lesions of the spinal cord resulting from irradiation. It is divided into two forms by the latent periods: transient RM and delayed RM. The delayed RM develops usually non-transverse myelopathy symptoms such as dissociated sensory disturbance, unilateral leg weakness, and gait disturbance with asymmetric steps. Spinal MRI shows initially cord swelling and long T1/T2 intramedullary lesion with enhancement, then exhibits cord atrophy. Histopathological findings of delayed RM are white matter necrosis, demyelination, venous wall thickening and hyalinization. Glial theory and vascular hypothesis have been proposed to explain its pathophysiology. Several therapies such as adrenocorticosteroid, anticoagulation and hyperbaric oxygen have been tried to this disease with variable benefits. Radiation plexopathy is classified into two major types by the location: radiation-induced brachial plexopathy (BP) and radiation-induced lumbosacral plexopathy (LSP). The BP initially emerges as arm and shoulder pain, whereas LSP as leg weakness. Myokymia and fasciculations are observed in both types. Electrophysiological study reveals findings of peripheral neuropathy. It is often difficult to distinguish the radiation plexopathy from cancer invasion to the plexus, but MRI is useful to differentiate between these diseases. Pathological findings are small vessel obstruction, thick fibrosis, axonal degeneration and demyelination. Its pathomechanism is presumed that radiation-induced fibrous tissue compresses the nerve root as well as microvascular obstruction of the nerve. Adrenocorticosteroid and anticoagulation are considered as the strategy for symptomatic relief.
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PMID:[Radiation myelopathy and plexopathy]. 1830 58

Electromyography (EMG) studies are a useful tool in anatomical localization of peripheral nerve and brachial plexus injuries. They are especially helpful in distinguishing between brachial plexopathy and nerve root injuries where surgical intervention may be indicated. EMG can also assist in providing prognostic information after nerve injury as well as after nerve repair. In this case report, a football player presented with weakness in his right upper limb after a traction/traumatic injury to the right brachial plexus. EMG studies revealed evidence of both pre- and postganglionic injury to multiple cervical roots. The injury was substantial enough to cause nerve root avulsions involving the C6 and C7 levels. Surgical referral led to nerve grafts targeted at regaining function in shoulder abduction and elbow flexion. After surgery, the patient's progress was monitored utilizing EMG to assist in identifying true axonal regeneration.
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PMID:Brachial plexopathy/nerve root avulsion in a football player: the role of electrodiagnostics. 1875 70

Most injuries to the neonatal brachial plexus occur acutely at birth, and are iatrogenic in origin. However, when weakness is accompanied by atrophy, nontraumatic etiologies should be considered. The differential diagnosis of chronic congenital brachial plexopathy includes cervical bone malformations, humeral osteomyelitis, varicella, and compression from various types of infantile tumors. An illustrative male infant delivered at 37 weeks of gestation with wasted musculature of the left upper arm, ipsilateral Horner's syndrome, and a hemidiaphragm is presented. On further examination, this patient manifested an underlying cervical tumor compressing the brachial plexus. Diagnostic steps leading to the pathologic identification of a solitary cervical myofibroma included physical examination, electromyography, radiographic imaging, and open biopsy. This report emphasizes the importance of differentiating acute from chronic congenital plexus palsy and of recognizing the possibility that infection or neoplasm may underlie the latter.
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PMID:Infantile myofibromatosis: a nontraumatic cause of neonatal brachial plexus palsy. 1880 67

Radiation-induced brachial plexopathy is an uncommon but devastating late complication seen in patients receiving radiation therapy to the chest wall and axilla. Treatment options are unfortunately limited. We report a case of a 59-year-old woman treated with radiation therapy for breast cancer 12 years earlier, who presented with loss of elbow flexion and marked shoulder weakness. Electromyogram and intraoperative stimulation of the musculocutaneous nerve branches were consistent with a proximal motor nerve conduction block. Microsurgical transfer of median and ulnar nerve fascicles to the biceps and brachialis branches of the musculocutaneous nerve, respectively, were performed. The patient recovered MRC grade 4/5 elbow flexion after surgery. The characteristics of this disorder and surgical treatment options are reviewed.
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PMID:Nerve transfer for elbow flexion in radiation-induced brachial plexopathy: a case report. 1884 22

Contralateral upper extremity weakness following resection of a frontal tumor is not unusual to neurosurgeons. The differential diagnosis is broad and includes postoperative brachial plexopathy, which is usually secondary to malpositioning. We report the first known case of postoperative brachial plexopathy secondary to sialadenitis. A 53-year-old woman who had undergone an uncomplicated right frontal craniotomy for resection of a right frontal metastatic lesion developed left upper extremity weakness as well as extensive left neck edema immediately postoperatively. The edema, tracking along the fascial plane of the neck, caused compression of the upper (more superficial) elements of the brachial plexus and ensuing plexopathy. The cause of the neck edema was found to be sialadenitis of the submandibular gland. With medical treatment, the edema slowly resolved and the patient regained full function of her left upper extremity within weeks. This unusual case represents a new etiology of postoperative brachial plexopathy, illustrates the clinical relevance of the anatomy of the neck fasciae, and broadens the differential diagnosis of contralateral weakness following craniotomy for resection of a brain tumor.
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PMID:An unusual anatomical explanation for contralateral upper extremity weakness after frontal craniotomy. 1971 69

This case report presents a 56-year-old man with right upper limb weakness which arose 22 years after initial local radiation treatment for a grade III fibrosarcoma. Nerve conduction studies revealed impairment of all three major upper limb nerves compared with the left, with particular impairment of the median and ulnar nerves in the most fibrotic area that had been irradiated. In addition, the patient received multiple courses of chemotherapy. The occurrence of radiation-induced brachial plexopathy should be considered in patients presenting with limb pain or weakness even many years after radiation therapy.
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PMID:Brachial neuropathy 22 years after radiation therapy for fibrosarcoma: a case report. 1991 50


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