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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
"controlled trials of treatment for neuralgic amyotrophy"
symptom
neuralgic amyotrophy
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