Mullins G M, O'Sullivan S S, Neligan A, Daly S, Galvin R J, Sweeney B J, McNamara B
Department of Neurology Cork University Hospital, Ireland.
Clin Neurol Neurosurg. 2007 Oct;109(8):661-6. doi: 10.1016/j.clineuro.2007.05.010. Epub 2007 Jul 10.
To establish the clinical characteristics, aetiology, neuro-physiological characteristics, imaging findings and other investigations in a cohort of patients with non-traumatic brachial plexopathy (BP).
A 3-year retrospective study of patients with non-traumatic BP identified by electromyography (EMG) and nerve conduction studies (NCS). Clinical information was retrieved from patients' medical charts.
Twenty-five patients were identified. Causes of BP included neuralgic amyotrophy (NA) (48%), neoplastic (16%), radiation (8%), post infectious (12%), obstetric (4%), rucksack injury (4%), thoracic outlet syndrome (4%) and iatrogenic (4%). Patients with NA presented acutely in 50%. The onset was subacute in all others. Outcome was better for patients with NA. All patients with neoplastic disease had a previous history of cancer. MRI was abnormal in 3/16 patients (18.8%). PET scanning diagnosed metastatic plexopathy in two cases.
NA was the most common cause of BP in our cohort and was associated with a more favourable outcome. The authors note potentially discriminating clinical characteristics in our population that aid in the assessment of patients with brachial plexopathies. We advise NCS and EMG be performed in all patients with suspected plexopathy. Imaging studies are useful in selected patients.
确定一组非创伤性臂丛神经病（BP）患者的临床特征、病因、神经生理学特征、影像学表现及其他检查结果。
对通过肌电图（EMG）和神经传导研究（NCS）确诊的非创伤性BP患者进行为期3年的回顾性研究。从患者病历中获取临床信息。
共确定25例患者。BP的病因包括神经性肌萎缩（NA）（48%）、肿瘤性（16%）、放射性（8%）、感染后（12%）、产科相关（4%）、背包损伤（4%）、胸廓出口综合征（4%）和医源性（4%）。50%的NA患者急性起病。其他所有患者起病均为亚急性。NA患者的预后较好。所有肿瘤性疾病患者均有癌症病史。16例患者中有3例（18.8%）MRI异常。PET扫描诊断出2例转移性丛神经病。
NA是我们研究队列中BP最常见的病因，且与更有利的预后相关。作者指出了我们研究人群中可能有助于评估臂丛神经病患者的鉴别性临床特征。我们建议对所有疑似丛神经病的患者进行NCS和EMG检查。影像学检查对部分患者有用。
