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[Pathogenesis and treatment of brachial plexus neuritis].
[neuralgic amyotrophy]
Neuralgic
amyotrophy
(
NA
,
also
known
as
Parsonage-
Turner
syndrome
)
is
a
distinct
peripheral
nervous
system
(
PNS
)
disorder
,
characterized
by
sudden
attacks
of
severe
neuropathic
pain
usually
in
the
shoulder
and
/
or
arm
.
The
neuralgia
commonly
disappears
after
a
few
days
to
weeks
,
and
consequently
patchy
paresis
with
amyotrophy
appears
.
The
available
evidence
suggests
that
NA
is
essentially
idiopathic
immune-mediated
neuritis
of
the
brachial
plexus
,
and
also
has
a
complex
pathogenesis
that
includes
an
underlying
predisposition
,
susceptibility
to
dysfunction
of
some
PNS
structure
,
and
a
trigger
for
the
attacks
,
such
as
viral
infection
,
vaccination
,
trauma
,
surgery
,
and
strenuous
exercise
.
Genetic
factors
also
contribute
to
the
pathogenesis
of
NA
,
and
thus
,
this
disorder
occurs
in
both
idiopathic
and
hereditary
forms
,
but
hereditary
one
is
considered
to
be
10
times
less
common
than
idiopathic
one
.
NA
has
been
considered
to
be
self-limiting
,
benign
disorder
showing
good
recovery
without
specific
treatments
.
However
,
recent
studies
have
indicated
that
the
long
-term
prognosis
of
NA
is
less
favorable
than
has
been
assumed
.
In
2009
,
a
Cochrane
review
identified
one
open
label
,
retrospective
series
,
the
results
of
which
suggested
that
administration
of
corticosteroids
in
the
acute
phase
of
NA
could
shorten
the
duration
of
painful
symptoms
and
also
accelerate
recovery
in
some
patients
.
We
recently
have
reported
that
intravenous
immunoglobulin
(
IVIg
)
with
methylpredonisolone
pulse
therapy
is
effective
for
motor
impairment
of
NA
.
Diseases
Validation
Diseases presenting
"specific treatments"
symptom
adrenomyeloneuropathy
neuralgic amyotrophy
primary effusion lymphoma
pyruvate dehydrogenase deficiency
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