[A case of brachial plexus neuropathy who presented with acute paralysis of the hand after sleep].
We report a 46-year-old woman who presented with acute paresis of the right hand and arm. She was well until when she noted a paresis and dysesthesia in her right hand in the morning. Neurological examination revealed weakness in the muscles which were supplied by lower cervical segments, with increased deep tendon reflexes in the right arm. Allen's test and Wright's test were positive. The nerve conduction studies disclosed a reduced CMAPs more severely by right median than ulnar nerve stimulation. The frequency and amplitude of the F waves was also reduced. Needle electromyogram showed a mild neurogenic pattern in the right hand muscles. Digital subtraction angiography revealed a tapering of the subclavian artery when the right arm was abducted. She underwent decompression surgery. A remarkable improvement of the symptoms was observed after surgery. Our patient suggests that brachial plexus neuropathy should be considered in the acute paresis of the hand after sleep, and that surgical procedure would lead to a successful outcome.
Iijima
Makiko
M
Department of Neurology, Juntendo Izu-Nagaoka Hospital, 1129 Nagaoka, Izu-Nagaoka, Tagata-gun, Shizuoka 410-2295, Japan.
Okuma
Yasuyuki
Y
Ohizumi
Hideki
H
Fujishima
Kenji
K
Goto
Keigo
K
Mizuno
Yoshikuni
Y
D000208:Acute Disease; D001917:Brachial Plexus / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000150:complications* / Q000601:surgery; D019299:Decompression, Surgical; D005260:Female; D006225:Hand; D006801:Humans; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology*; D012890:Sleep