Miller J D, Pruitt S, McDonald T J
North Mississippi Neurosurgical Services, PA, Tupelo 38801, USA.
Am Fam Physician. 2000 Nov 1;62(9):2067-72.
Patients with acute brachial plexus neuritis are often misdiagnosed as having cervical radiculopathy. Acute brachial plexus neuritis is an uncommon disorder characterized by severe shoulder and upper arm pain followed by marked upper arm weakness. The temporal profile of pain preceding weakness is important in establishing a prompt diagnosis and differentiating acute brachial plexus neuritis from cervical radiculopathy. Magnetic resonance imaging of the shoulder and upper arm musculature may reveal denervation within days, allowing prompt diagnosis. Electromyography, conducted three to four weeks after the onset of symptoms, can localize the lesion and help confirm the diagnosis. Treatment includes analgesics and physical therapy, with resolution of symptoms usually occurring in three to four months. Patients with cervical radiculopathy present with simultaneous pain and neurologic deficits that fit a nerve root pattern. This differentiation is important to avoid unnecessary surgery for cervical spondylotic changes in a patient with a plexitis.
急性臂丛神经炎患者常被误诊为颈椎病神经根病。急性臂丛神经炎是一种罕见的疾病，其特征是肩部和上臂严重疼痛，随后出现明显的上臂无力。无力之前疼痛的时间特征对于及时诊断以及区分急性臂丛神经炎和颈椎病神经根病很重要。肩部和上臂肌肉组织的磁共振成像可能在数天内显示神经失用，从而实现及时诊断。症状出现三到四周后进行的肌电图检查可以定位病变并有助于确诊。治疗包括使用镇痛药和物理治疗，症状通常在三到四个月内缓解。颈椎病神经根病患者同时出现符合神经根模式的疼痛和神经功能缺损。这种区分对于避免对患有臂丛神经炎的患者因颈椎退变进行不必要的手术很重要。
