Nakamura Takumi, Kawarabayashi Takeshi, Seino Yusuke, Shoji Mikio
Department of Neurology, Hirosaki University Graduate School of Medicine.
Rinsho Shinkeigaku. 2017 Jul 29;57(7):383-386. doi: 10.5692/clinicalneurol.cn-001023. Epub 2017 Jul 24.
A 17-year-old man with no familial history developed motor and sensory disturbance of the left upper limb a few days after starting push-up exercise. Neurological examination revealed broad weakness and radial sensory disturbance of the left upper limb and magnetic resonance neurography showed laterality of brachial plexus intensity signals. Therefore, we suspected left brachial plexopathy. However, a nerve conduction study showed a broad disturbance that could not be explained by only brachial plexopathy. Genetic tests revealed a diagnosis of hereditary neuropathy with liability to pressure palsies (HNPP). HNPP should be included in the differential diagnosis for neuropathy due to slight exercise or nerve compression even when familial history is negative.
一名17岁无家族病史的男性在开始俯卧撑运动几天后出现左上肢运动和感觉障碍。神经系统检查发现左上肢广泛无力和桡侧感觉障碍,磁共振神经成像显示臂丛神经强度信号存在单侧性。因此,我们怀疑是左侧臂丛神经病变。然而,神经传导研究显示的广泛障碍无法仅用臂丛神经病变来解释。基因检测确诊为遗传性压力易感性神经病(HNPP)。即使家族史为阴性,对于因轻微运动或神经受压导致的神经病变,鉴别诊断时也应考虑HNPP。