Neuralgic amyotrophy with hourglass-like constrictions:A case report

作     者：Mi-Hyeon Bang Ha-Lim Song Seok Hahn Wanil Kim Hwan-Kwon Do 

作者机构：Department of Physical Medicine and RehabilitationHaeundae Paik HospitalInje University College of MedicineBusan 48108South Korea Department of RadiologyHaeundae Paik HospitalInje University College of MedicineBusan 48108South Korea Division of BiochemistryDepartment of Convergence Medical ScienceInstitute of Medical ScienceGyeongsang National University College of MedicineJinju 52727South Korea Department of Physical Medicine and RehabilitationDongnam Institute of Radiological and Medical SciencesBusan 46033South Korea 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2024年第12卷第34期

页      面：6728-6735页

学科分类：1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100215[医学-康复医学与理疗学] 10[医学] 

主　　题：Neuralgic amyotrophy Cervical radiculopathy Hourglass-like focal constriction Paraspinal muscle Magnetic resonance neurography Case report 

摘      要：BACKGROUND Neuralgic amyotrophy(NA)is a rare disease with sudden upper limb pain followed by affected muscle *** most commonly affected area in NA is the upper part of the brachial plexus,and the paraspinal muscles are rarely affected(1.5%),making these cases difficult to distinguish from cervical *** SUMMARY A 76-year-old male presented to the emergency department with left hip pain *** undergoing left femoral neck fracture surgery,he experienced sudden left shoulder pain for 10 days with subsequent left arm *** spine computed tomography revealed mild right asymmetric intervertebral disc bulging with a decreased C5-6disc *** weeks later,an electrodiagnostic study confirmed brachial plexopathy findings involving the cervical *** resonance neurography was performed for a differential *** enhancement was identified at the upper trunk of the brachial plexus,including the C5 nerve root.A suprascapular nerve hourglass-like focal constriction(HLFC)was also identified,confirming *** being diagnosed with NA,the patient received 15 mg prednisolone,twice daily,for 3 *** therapy was initiated,including left arm strengthening exercises and electrical stimulation *** shoulder muscle strength significantly improved one CONCLUSION NA s unique features like HLFC and paraspinal involvement are crucial for accurate diagnosis,avoiding confusion with cervical radiculopathy.