title: [Cervico-brachialgias, a delicate differential diagnosis: apropos of a patient with recurrent loss of consciousness in herniated disk].
abstract: A protrusion of a intervertebral disc can be the cause of a painful hand-shoulder syndrome. Such a situation can be difficult to interpret particularly if it is associated with repeated (recurrent?) loss of consciousness. The presented patient illustrates the complexity of this syndrome and emphasizes the importance of the history and clinical examination. One should not be reluctant to repeat these investigations, in particular the examination of reflexes. The value of nuclear magnetic resonance studies in the diagnostic approach is outlined. A cervical disc protrusion is part of the differential diagnosis of unconsciousness of undetermined cause. Its pathogenesis remains to be elucidated. In the presented patient the causal relation is unquestionable since symptoms subsided after surgery. It is an example over our limited knowledge about the pathophysiology of peripheral nervous-system diseases.
authors.affiliation: Chirurgie St-Léonard, Clinique de jour, St-Gall.
authors.forename: Y
authors.initials: Y
authors.lastname: Brühlmann
authors.forename: G R
authors.initials: GR
authors.lastname: Sennwald
mesh_terms: D002574:Cervical Vertebrae; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009192:Myelography; D012008:Recurrence; D012019:Reflex Sympathetic Dystrophy / Q000209:etiology*; D014474:Unconsciousness / Q000209:etiology*