Al Khalili Yasir, Jain Sameer, Lam Jason C., DeCastro Alexei
Virginia Commonwealth University
Thomas Jefferson University Hospital
Brachial neuritis, also called neuralgic amyotrophy or Parsonage-Turner syndrome, is a neuromuscular syndrome involving the peripheral nerves. The condition is not well understood and is often underdiagnosed. Though brachial neuritis was previously thought to be an inflammatory process, the underlying etiology remains unclear, with immune-mediated, mechanical, and genetic factors associated with the condition. The primary characteristic symptoms of brachial neuritis are sudden unilateral or bilateral pain in the shoulder girdle, followed by the onset of muscle weakness. Sensory deficits may also be noted in some patients. Typically, the symptoms radiate to the neck, arms, and forearms and may last from a few days to an average of 4 weeks. Clinicians may have difficulty diagnosing brachial neuritis due to the condition's multifocal symptoms, various presentations, and the delayed manifestation of pathophysiologic changes on testing. To avoid misdiagnosis, clinicians must be familiar with the clinical course of brachial neuritis and be able to differentiate it from similar conditions, as an inaccurate diagnosis can lead to unnecessary surgery and increased complications. Brachial neuritis is primarily clinically diagnosed; however, diagnostic studies, including nerve conduction, needle electromyography (EMG), laboratory, and imaging, are typically utilized for diagnostic confirmation. The approach to treatment is divided into acute and chronic phases, with therapies varying depending on the progression of symptoms. However, management often includes supportive therapies, physical therapy, corticosteroids, and intravenous immunoglobulin. In some patients, surgical procedures such as neurolysis may be considered. This activity for healthcare professionals aims to enhance learners' competence in recognizing brachial neuritis, excluding differential diagnoses, selecting appropriate diagnostic tests, managing the acute and chronic phases of the condition, and fostering effective interprofessional teamwork to improve outcomes.
臂丛神经炎，也称为神经痛性肌萎缩或帕森热-特纳综合征，是一种累及周围神经的神经肌肉综合征。这种病症尚未被完全了解，且常常被漏诊。尽管臂丛神经炎以前被认为是一种炎症过程，但其潜在病因仍不清楚，免疫介导、机械和遗传因素都与该病症有关。臂丛神经炎的主要特征症状是肩带突然出现单侧或双侧疼痛，随后出现肌肉无力。一些患者也可能出现感觉障碍。通常，症状会放射至颈部、手臂和前臂，可能持续数天至平均4周。由于该病症具有多灶性症状、多种表现形式以及检测时病理生理变化的延迟显现，临床医生在诊断臂丛神经炎时可能会遇到困难。为避免误诊，临床医生必须熟悉臂丛神经炎的临床病程，并能够将其与类似病症区分开来，因为不准确的诊断可能导致不必要的手术和更多并发症。臂丛神经炎主要通过临床诊断；然而，诊断性研究，包括神经传导、针电极肌电图（EMG）、实验室检查和影像学检查，通常用于确诊。治疗方法分为急性期和慢性期，治疗方法会根据症状的进展而有所不同。然而，治疗通常包括支持性治疗、物理治疗、皮质类固醇和静脉注射免疫球蛋白。在一些患者中，可能会考虑诸如神经松解术等外科手术。这项针对医疗专业人员的活动旨在提高学习者识别臂丛神经炎的能力，排除鉴别诊断，选择合适的诊断测试，管理该病症的急性期和慢性期，并促进有效的跨专业团队合作以改善治疗效果。
