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Acute brachial plexus neuropathy with involvement of cranial nerves IX, X, XI and XII.
[neuralgic amyotrophy]
Acute
brachial
plexus
neuropathy
is
characterized
by
acute
onset
of
shoulder
girdle
and
arm
pain
,
followed
by
weakness
of
the
shoulder
and
arm
muscles
.
It
affects
primarily
nerves
of
the
upper
trunk
of
the
brachial
plexus
and
the
long
thoracic
nerve
.
Cranial
nerve
involvement
is
an
infrequent
association
and
implies
a
diagnostic
challenge
.
We
report
a
unique
case
of
acute
brachial
plexus
neuropathy
with
involvement
of
the
cranial
nerves
IX
,
X
,
XI
and
XII
.
F
ifty
six
year
-old
woman
who
developed
acute
dysphonia
,
dysphagia
and
left
shoulder
pain
,
followed
,
six
days
later
,
by
left
arm
weakness
.
Needle
examination
showed
only
fibrillation
potentials
and
positive
sharp
waves
in
the
left
deltoid
muscle
.
MRI
of
the
brachial
plexus
shows
enlargement
of
the
trunks
,
cords
and
terminal
branches
,
with
mild
gadolinium
enhancement
.
This
case
illustrates
the
unique
presentation
of
neuralgic
amyotrophy
with
involvement
of
nerves
outside
the
brachial
plexus
,
and
the
importance
of
MRI
for
diagnosis
,
in
the
absence
of
electrophysiologic
involvement
.
Diseases
Validation
Diseases presenting
"cords and terminal branches"
symptom
neuralgic amyotrophy
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