title: Proximal arm weakness is the most common presentation in young Korean soldiers diagnosed as having hereditary neuropathy with liability to pressure palsy (HNPP).
abstract: OBJECTIVE
  Because patients with hereditary neuropathy with liability to pressure palsy (HNPP) are diagnosed mostly in their 20s, they are likely to experience their first major neurological symptoms during military training. We aimed to analyse the clinical characteristics and electrodiagnostic study findings of patients diagnosed with HNPP during their military service.
  
  
  METHODS
  We identified patients diagnosed as having HNPP in 2011-2014 and investigated their initial symptom presentation, the location and severity of their weakness, the causative event, the results of electrodiagnostic studies and the results of the genetic analysis of the PMP-22 gene.
  
  
  RESULTS
  Among the 36 patients included in the study, 19 (52.8%) patients had upper extremity paraesthesia with proximal arm weakness caused by brachial plexus lesion. Distal upper extremity symptoms were found in 12 (33.3%) patients, and leg paraesthesia was present only in five (13.9%) patients. Among the 19 patients who had proximal arm weakness, the most common cause of weakness was the performance of push-ups as a punishment (36.8%), and strenuous push-up exercise was the second cause of this symptom (21.1%).
  
  
  CONCLUSIONS
  Brachial plexus lesion leading to proximal arm weakness and paraesthesia was the most common presentation in soldiers with HNPP, and strenuous push-up activity was the major leading causative event in this condition.
authors.affiliation: Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors.forename: Kyoung-Eun
authors.initials: KE
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors.forename: J
authors.initials: J
authors.lastname: Yeom
mesh_terms: D001132:Arm; D001176:Arthrogryposis / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D020516:Brachial Plexus Neuropathies / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D015331:Cohort Studies; D015417:Hereditary Sensory and Motor Neuropathy / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D008297:Male; D008889:Military Personnel; D018908:Muscle Weakness / Q000175:diagnosis* / Q000209:etiology; D009185:Myelin Proteins / Q000235:genetics; D009431:Neural Conduction / Q000502:physiology; D010292:Paresthesia / Q000175:diagnosis* / Q000209:etiology; D056910:Republic of Korea; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D009185:Myelin Proteins; C073687:PMP22 protein, human
keywords: brachial plexopathy; hereditary neuropathy with liability to pressure palsy (HNPP); soldier