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Treatment for idiopathic and hereditary neuralgic amyotrophy (brachial neuritis).
[neuralgic amyotrophy]
Neuralgic
amyotrophy
(
also
know
as
Parsonage-
Turner
syndrome
or
brachial
plexus
neuritis
)
is
a
distinct
peripheral
nervous
system
disorder
characterised
by
episodes
(
attacks
)
of
extreme
neuropathic
pain
and
rapid
multifocal
weakness
and
atrophy
in
the
upper
limbs
.
Neuralgic
amyotrophy
has
both
an
idiopathic
and
hereditary
form
,
with
similar
clinical
symptoms
but
generally
an
earlier
age
of
onset
and
more
episodes
in
the
hereditary
form
.
The
current
hypothesis
is
that
the
episodes
are
caused
by
an
immune-mediated
response
to
the
brachial
plexus
.
Recovery
is
slow
,
in
months
to
years
,
and
many
patients
are
left
with
residual
pain
and
decreased
exercise
tolerance
of
the
affected
limb
(
s
)
.
Anecdotal
evidence
suggests
that
corticosteroids
may
relieve
pain
or
help
improve
functional
recovery
.
The
objective
was
to
provide
a
systematic
review
of
all
randomised
clinical
trials
of
treatment
in
neuralgic
amyotrophy
.
We
searched
the
Cochrane
Neuromuscular
Disease
Group
Trials
Register
(
April
2
2009
)
,
MEDLINE
(
January
1966
to
April
2
2009
)
,
EMBASE
(
January
1980
to
April
2
2009
)
,
CINAHL
(
January
1982
to
April
2
2009
)
,
and
LILACS
(
January
1982
to
April
2
2009
)
for
randomised
controlled
trials
of
treatment
for
neuralgic
amyotrophy
.
Any
randomised
or
quasi-randomised
trial
of
any
intervention
for
neuralgic
amyotrophy
would
be
included
in
the
review
.
Two
review
authors
extracted
the
data
(
RH
,
NvA
)
and
two
authors
assessed
study
quality
and
performed
data
extraction
independently
(
NvA
,
BvE
)
.
No
randomised
or
quasi-randomised
trials
were
identified
.
In
30
articles
anecdotal
evidence
was
found
on
treatment
for
neuralgic
amyotrophy
.
Only
three
of
these
articles
contained
more
than
10
treated
cases
,
with
one
providing
sufficient
details
to
calculate
the
primary
and
secondary
outcome
measures
for
this
review
.
At
this
moment
there
is
no
evidence
from
randomised
trials
on
any
form
of
treatment
for
neuralgic
amyotrophy
.
Evidence
from
one
open
-label
retrospective
series
suggests
that
oral
prednisone
given
in
the
first
month
after
onset
can
shorten
the
duration
of
the
initial
pain
and
leads
to
earlier
recovery
in
some
patients
.
Randomised
clinical
trials
are
needed
to
establish
the
efficacy
of
treatment
with
corticosteroids
or
other
immune-modulating
therapies
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated