Noushad Muhammed Ameen, Limnatitou Demetra, Bhattacharjee Shakya, Mohd Nor Azlisham
Neurology, University Hospitals Plymouth NHS Trust, Plymouth, UK
Neurorehabilitation, University Hospitals Plymouth NHS Trust, Plymouth, UK.
BMJ Case Rep. 2021 Apr 13;14(4):e242113. doi: 10.1136/bcr-2021-242113.
Hepatitis E virus (HEV)-associated neuralgic amyotrophy (NA) is often bilateral and severe, involving structures outside the brachial plexus, such as the phrenic nerves or the lumbosacral plexus. We report a case of an HEV-positive man who had presented with brachial neuritis, with significant phrenic nerve involvement, resulting in diaphragmatic paralysis requiring non-invasive ventilation. Prognosis of HEV-associated NA is often unfavourable and recovery is usually incomplete. Identifying HEV-associated NA early could potentially aid in prognostication and management planning, as clinicians and patients would be expectant of its potential features and severity. Respiratory function should be monitored in patients with HEV who suffer from NA, as diaphragmatic paralysis could potentially lead to severe respiration difficulties requiring ventilatory support.
戊型肝炎病毒（HEV）相关的神经性肌萎缩（NA）通常是双侧且严重的，累及臂丛神经以外的结构，如膈神经或腰骶丛神经。我们报告一例HEV阳性男性病例，该患者表现为臂神经炎，伴有明显的膈神经受累，导致膈肌麻痹，需要无创通气。HEV相关NA的预后通常不佳，恢复通常不完全。早期识别HEV相关NA可能有助于预后评估和管理规划，因为临床医生和患者会对其潜在特征和严重程度有所预期。患有NA的HEV患者应监测呼吸功能，因为膈肌麻痹可能导致严重呼吸困难，需要通气支持。
