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Bilateral neuralgic amyotrophy presenting with left vocal cord and phrenic nerve paralysis.
[neuralgic amyotrophy]
This
article
reports
the
difference
between
neuralgic
amyotrophy
and
neuropathy
caused
by
chemotherapy
and
radiation
treatment
which
manifested
with
severe
shoulder
pain
followed
by
marked
weakness
of
bilateral
upper
arms
and
involvement
of
cranial
nerves
.
A
62
-
year
-old
man
presented
with
acute
severe
neuropathic
pain
at
the
left
shoulder
,
bilateral
shoulder
weakness
,
hoarseness
of
voice
from
vocal
cord
palsy
,
and
respiratory
insufficiency
from
left
diaphragm
palsy
,
which
all
occurred
sequentially
over
a
1
-
month
period
.
The
diagnosis
of
neuralgic
amyotrophy
was
supported
and
differentiated
from
tumor
-induced
and
radiation-induced
neuropathy
by
clinical
presentation
,
electrophysiologic
and
imaging
studies
.
Unlike
previous
reports
of
the
onset
of
neuralgic
amyotrophy
being
associated
with
initiation
of
radiation
treatment
in
cancer
patients
,
this
report
demonstrates
that
neuralgic
amyotrophy
can
occur
at
any
point
of
the
malignant
disease
process
after
radiation
and
chemotherapy
.