Neuralgic amyotrophy in children

Abstract

Introduction: Neuralgic amyotrophy (NA) is characterized by the clinical triad of pain, muscle weakness/atrophy, and sensory symptoms.

Methods: We retrospectively identified children (≤18 years old) over the course of 15 years (2003-2017) at a single pediatric center.

Results: We included 22 patients (8 females and 14 males, 6-18 years old); pain was the presenting manifestation in all of them. Clinical weakness involving the periscapular muscles was observed in 16 patients and scapular winging in 13 patients. Two patients had preceding viral infection. Electromyography was performed in 21 patients: sensory nerve abnormalities were detected in 5, and neurogenic changes were most commonly observed in the serratus anterior muscle. Treatment was mainly supportive, although 4 patients received immunotherapy. Persistent pain and residual motor deficits were observed in more than half of the patients at follow-up.

Discussion: NA is rare in children but clinicians should be aware of this entity to avoid delays in diagnosis. In our series, presentation was similar to that seen in adults. Muscle Nerve 57: 932-936, 2018.

Keywords: EMG; Parsonage−Turner syndrome; brachial plexitis; children; neuralgic amyotrophy; neuropathy.