Acute brachial neuritis
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Synopsis
This condition involves multiple motor and sensory nerves of the brachial plexus, with a predilection of motor nerves. Patients typically present with unilateral acute to subacute shoulder, arm, or axillary pain followed by variable weakness and sensory change, often involving the scapula and upper arm. Weakness can begin anywhere from 1 day to several weeks after the onset of pain.
Bilateral brachial neuritis has been reported in up to 30% of cases, although symptoms tend to be asymmetric. Rare cases can involve nerves outside of the brachial plexus, including the phrenic and recurrent laryngeal nerves, leading to respiratory issues. Most patients will experience moderate to complete recovery that occurs over months.
Codes
ICD10CM:G54.5 – Neuralgic amyotrophy
SNOMEDCT:
26609002 – Neuralgic amyotrophy
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Focal nerve entrapment
- Amyotrophic lateral sclerosis (ALS)
- Multifocal motor neuropathy
- Vasculitic neuropathy (see vasculitis)
- Chronic inflammatory demyelinating polyneuropathy (CIDP)
- Progressive muscular atrophy
- Multifocal acquired demyelinating sensory and motor neuropathy
- Multifocal acquired motor axonopathy
- Hereditary neuropathy with liability to pressure palsy
- Flail arm or flail leg syndrome
- Mass lesion at apex of lung
- Postradiation plexopathy
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:03/18/2021
Last Updated:03/22/2021
Last Updated:03/22/2021