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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
Validation
Diseases presenting
"rare neurological disorder"
symptom
alexander disease
neuralgic amyotrophy
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