Idiopathic neuralgic amyotrophy: an illustrative case report.
OBJECTIVE
To describe the case of a patient diagnosed with neuralgic amyotrophy (NA) illustrating pertinent aspects of differential diagnosis, the use of clinical neurophysiological procedures to aid in establishing the diagnosis, and issues of management.


METHODS
A 39-year-old male soldier presented with a rapid onset of marked loss of left shoulder movement. This started acutely early one morning as a sharp, severe lower neck pain progressing over the following 2 weeks to a less severe dull ache in the left shoulder and arm. Pain was rapidly replaced with weakness. Physical examination and electrodiagnostic investigation helped establish a diagnosis of NA.


RESULTS
The patient was reassured that this is normally a self-limiting condition. Range of motion exercises progressing to a strengthening program was prescribed. He was progressing well; however, we lost contact because of his commitments in the armed service.


CONCLUSIONS
When a patient presents with shoulder and arm pain of neurogenic origin, NA should be a consideration. Differentiating NA from radiculopathy is especially important in making management decisions. With a careful history and physical examination, the diagnosis may be made without the need for ancillary investigations. Neuralgic amyotrophy is a self-limiting condition requiring reassurance and monitoring.
Rix
George D W
GD
Anglo-European College of Chiropractic, Bournemouth, UK. grix@aecc.ac.uk
Rothman
Edward H
EH
Robinson
Aidan W D
AW
D000328:Adult; D020968:Brachial Plexus Neuritis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D003937:Diagnosis, Differential; D004568:Electrodiagnosis; D005081:Exercise Therapy; D006801:Humans; D008297:Male; D010808:Physical Examination; D011843:Radiculopathy / Q000175:diagnosis