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Evaluation of prednisolone treatment in the acute phase of neuralgic amyotrophy: an observational study.
[neuralgic amyotrophy]
Effective
treatment
for
neuralgic
amyotrophy
(
NA
)
,
a
disabling
brachial
plexus
syndrome
of
supposed
immunomediated
origin
,
is
currently
lacking
.
Given
the
circumstantial
evidence
of
a
beneficial
effect
of
prednisolone
on
pain
and
paresis
,
this
report
evaluates
the
effects
of
prednisolone
treatment
administered
in
the
acute
phase
in
a
retrospective
case
series
of
50
NA
patients
.
Baseline
variables
(
eg
,
age
,
sex
,
type
of
NA
and
number
of
attacks
)
,
treatment
variables
(
eg
,
time
until
treatment
,
regimen
and
use
of
analgesics
)
and
outcome
measures
(
eg
,
duration
and
severity
of
pain
,
time
course
and
severity
of
paresis
and
functional
outcome
)
were
statistically
analysed
and
compared
with
a
historical
control
group
of
203
untreated
NA
patients
.
The
baseline
characteristics
of
the
two
patient
groups
were
comparable
.
The
median
time
until
initial
pain
relief
was
lower
in
the
study
group
(
12
.
5
days
vs
20
.
5
days
)
,
and
a
significantly
higher
percentage
already
recovered
strength
in
the
first
month
of
treatment
(
18
%
vs
6
.
3
%
;
p
=
0
.
011
)
.
Twelve
per
cent
had
fully
recovered
within
1
year
,
while
this
was
1
%
for
the
controls
(
p
<
0
.
001
)
,
with
the
proportion
reporting
a
"
good
"
12
-
month
outcome
also
being
higher
(
44
%
vs
10
.
7
%
;
p
<
0
.
001
)
.
Side
effects
were
reported
by
20
%
,
but
none
led
to
a
discontinuation
of
treatment
.
Oral
prednisolone
seems
effective
in
the
acute
phase
of
neuralgic
amyotrophy
with
the
current
results
supporting
previous
case
reports
.
A
regimen
of
oral
prednisolone
is
therefore
recommended
in
the
acute
phase
of
the
syndrome
pending
a
prospective
,
randomised
trial
verifying
the
results
obtained
.
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neuralgic amyotrophy
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