Neuralgic amyotrophy associated with hepatitis E virus.

[neuralgic amyotrophy]

Neuralgic amyotrophy (NA ) is characterised by neuropathic pain and patchy paresis of the upper or lower limbs , usually involving the upper and middle trunks of the brachial plexus . The aetiology of NA is varied , with precipitating factors that include trauma , surgery , pregnancy , inoculations and infections . Deranged liver enzymes have been noted in previous NA reports but no cause identified . We describe a case of bilateral NA in a 53 -year -old man who presented with peripheral neuropathy and isolated derangement of liver enzymes . Serology was positive for hepatitis E infection and negative for other infections previously described to be associated with NA . The diagnosis was supported by electrophysiological findings . This case report suggests that hepatitis E is a potential cause of NA that had not previously been described in the literature , and further supports a proposed immune pathogenesis underlying the condition .