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Long-term pain, fatigue, and impairment in neuralgic amyotrophy.
[neuralgic amyotrophy]
Recently
,
it
has
become
clear
that
neuralgic
amyotrophy
(
NA
;
idiopathic
and
hereditary
brachial
plexus
neuropathy
)
has
a
less
optimistic
prognosis
than
usually
assumed
.
To
optimize
treatment
and
management
of
these
patients
,
one
needs
to
know
the
residual
symptoms
and
impairments
they
suffer
.
Therefore
,
the
objective
of
this
study
was
to
describe
the
prevalence
of
pain
,
psychologic
symptoms
,
fatigue
,
functional
status
,
and
quality
of
life
in
patients
with
NA
.
Neurology
outpatient
department
of
an
academic
teaching
hospital
.
NA
patients
(
N
=
89
)
were
studied
,
and
clinical
details
were
recorded
.
Self-report
data
were
on
average
collected
2
years
after
the
onset
of
the
last
NA
episode
.
Pain
was
assessed
with
the
McGill
Pain
Questionnaire
,
fatigue
with
the
Checklist
Individual
Strength
,
and
psychologic
distress
with
the
Symptom
Checklist
90
.
Functional
status
and
handicap
were
assessed
with
the
modified
Rankin
Scale
and
Medical
Outcomes
Study
36
-
Item
Short
-
Form
Health
Survey
.
P
ain
was
usually
localized
in
the
right
shoulder
and
upper
arm
,
matching
the
clinical
predilection
site
for
paresis
in
NA
.
About
a
quarter
to
a
third
of
the
patients
reported
significant
long
-term
pain
and
fatigue
,
and
half
to
two
thirds
still
experienced
impairments
in
daily
life
.
Over
one
third
of
the
individual
patients
suffered
from
severe
fatigue
.
The
group
did
not
fulfill
the
criteria
of
chronic
fatigue
or
major
psychologic
distress
.
There
was
no
correlation
of
pain
or
fatigue
with
the
level
of
residual
paresis
on
a
Medical
Research
Council
scale
,
but
patients
with
a
comorbid
condition
fared
worse
than
patients
without
.
A
significant
number
of
NA
patients
suffer
from
persistent
pain
and
fatigue
,
leading
to
impairment
.
Symptoms
were
not
correlated
with
psychologic
distress
.
This
makes
it
likely
that
they
are
caused
by
residual
shoulder
or
arm
dysfunction
but
not
as
part
of
a
chronic
pain
or
fatigue
syndrome
in
these
patients
.
Diseases
Validation
Diseases presenting
"fatigue"
symptom
benign recurrent intrahepatic cholestasis
cholangiocarcinoma
congenital adrenal hyperplasia
cowden syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dracunculiasis
erdheim-chester disease
esophageal carcinoma
fabry disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kabuki syndrome
lymphangioleiomyomatosis
neuralgic amyotrophy
pleomorphic liposarcoma
systemic capillary leak syndrome
triple a syndrome
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
x-linked adrenoleukodystrophy
This symptom has already been validated