Progressive arm weakness and tonic hand spasm from multifocal motor neuropathy in the brachial plexus.
A 50-year-old waitress presented with a 10-year history of progressive weakness in her right arm without atrophy and with tonic hand spasms suggesting a central motor disorder. Electromyography, however, disclosed chronic neurogenic changes including fasciculations and atypical cramps. Isolated motor conduction block in the right brachial plexus suggested a variant of multifocal motor neuropathy. Strength recovered and cramps disappeared after intravenous immunoglobulins. Motor neuropathies may thus manifest with features of central motor disorders.
Veltkamp
R
R
Department of Neurology, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. roland_veltkamp@med.uni-heidelberg.de
Krause
M
M
Schranz
C
C
Meinck
H-M
HM
D000200:Action Potentials / Q000502:physiology; D001132:Arm / Q000503:physiopathology; D001917:Brachial Plexus / Q000503:physiopathology*; D004574:Electromagnetic Fields; D004576:Electromyography; D005260:Female; D006225:Hand / Q000503:physiopathology; D015417:Hereditary Sensory and Motor Neuropathy / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007167:Immunotherapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D018908:Muscle Weakness / Q000503:physiopathology* / Q000628:therapy; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D009431:Neural Conduction / Q000502:physiology; D010146:Pain / Q000209:etiology; D013035:Spasm / Q000503:physiopathology* / Q000628:therapy
D007136:Immunoglobulins