Idiopathic neuralgic amyotrophy in children. Case report, 4 year follow up and review of the literature.

[neuralgic amyotrophy]

Idiopathic neuralgic amyotrophy (INA ) is a neurological disorder with a suspected autoimmune cause , and is characterized by a sudden onset of pain and subsequent atrophies of the arm and shoulder muscles . It has rarely been documented in children , but it has been suggested that the prognostic outcome is worse in children compared with adults .We present a case and 4 year follow up of severe INA in a 12 -year -old boy along with a thorough review of reported cases in children , to provide an overview of the paediatric phenotype and prognosis .The patient presented with severe pain and a subsequent paresis around the right shoulder girdle . Blood tests , MRI and X-ray of the shoulder were all normal . Electromyography revealed patchy denervation of individual nerves of the brachial plexus . At 5 months he started recovering , but full recovery was only achieved after 3 -4 years . We then reviewed the literature and identified 58 paediatric cases of INA . In total , 63 % made a full recovery , 25 % made a partial , and 13 % made no recovery . Overall , recovery was quick with a mean recovery time of 11 .1 months . Specific preceding events such as osteomyelitis , viral- and upper airway infections were frequently associated with INA , but with an age dependent pattern .INA is a rare neurological disorder , especially in children . When compared with adults , pain and bilateral affection seems less common , and recovery is quick . Although limited by its retrospective nature , this review suggests that the paediatric phenotype is different and milder from that of adults . It also indicates a better prognosis in children than previously anticipated .

Diseases
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Diseases presenting "patchy denervation" symptom

neuralgic amyotrophy

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