Tsuboi Hirofumi, Sugeno Naoto, Nishiyama Ayumi, Tateyama Maki, Aoki Masashi
Department of Neurology, Tohoku University School of Medicine.
Rinsho Shinkeigaku. 2013;53(4):312-5. doi: 10.5692/clinicalneurol.53.312.
A 28-year-old man noticed weakness in his left arm when he woke up. He was diagnosed as left radial nerve palsy and managed conservatively at a local hospital. A few days later, severe pain of the brachium appeared. Although severe pain improved in a year, dysesthesia and muscle atrophy remained. On admission, muscle weakness and atrophy were found in muscles innervated predominantly by the left radial nerve. In addition, needle-electromyography and computed tomography revealed the involvement of muscles innervated by the left suprascapular, long thoracic and axillary nerves, and we diagnosed the patient as neuralgic amyotrophy. Neuralgic amyotrophy should be kept in mind in diagnosing acute onset, painful radial palsy.
一名28岁男性醒来时发现左臂无力。他被诊断为左侧桡神经麻痹,并在当地医院接受保守治疗。几天后,出现了严重的臂部疼痛。尽管严重疼痛在一年内有所改善,但感觉异常和肌肉萎缩仍然存在。入院时,发现主要由左侧桡神经支配的肌肉存在肌无力和萎缩。此外,针极肌电图和计算机断层扫描显示左侧肩胛上神经、胸长神经和腋神经支配的肌肉也受到累及,我们将该患者诊断为神经性肌萎缩。在诊断急性起病、疼痛性桡神经麻痹时应考虑到神经性肌萎缩。