Two cases of neuralgic amyotrophy (idiopathic brachial plexus neuropathy) in children
are presented and combined with a review of the literature. Difficulties in establishing
the diagnosis are illustrated, and we give an overview of the phenotype of childhood
neuralgic amyotrophy and its distinctions from the adult type. Pain, in adult cases
present in over 95 % of the cases, is less frequent in children, and its absence by
no means excludes the diagnosis. In children under 8 weeks of age, the literature
shows that a subsequent osteomyelitis of the shoulder or arm always seems to be involved,
which warrants a close follow-up. Overall, recovery is less favourable in children,
but when they fully recover they seem to do so in a shorter period of time than adults.
We conclude that neuralgic amyotrophy in children is distinct from the adult variety,
and that it has a definite place in the differential diagnosis of a sudden limp arm,
even if it is painless.
Key words
Neuralgic amyotrophy - Brachial plexus - Children
References
- 1
Alfen van N, van Engelen B GM.
Lumbosacral plexus neuropathy: a case report and review of the literature.
Clin Neurol Neurosurg.
1997;
99
138-141
- 2
Alfen van N, Engelen van B GM, Reinders J WC, Kremer H, Gabreëls F JM.
The natural history of hereditary neuralgic amyotrophy in the Dutch population.
Brain.
2000;
123
718-723
- 3
Bale J F, Thompson J A, Petajan J H, Ziter F A.
Childhood brachial plexus neuropathy.
J Pediatr.
1979;
95
741-742
- 4
Bardos V, Somodska V.
Epidemiologic study of a brachial plexus neuritis outbreak in northeast Czechoslovakia.
World Neurol.
1961;
2
973-979
- 5
Charles L M, Jayam-Trouth A.
Brachial plexus neuropathy. Three cases in children.
Am J Dis Child.
1980;
34
299-300
- 6
Clay S A.
Osteomyelitis a cause of brachial plexus neuropathy.
Am J Dis Child.
1982;
136
1054-1056
- 7
Devathasan G, Tong H I.
Neuralgic amyotrophy: criteria for diagnosis and a clinical with electromyographic
study of 21 cases.
Aust N Z J Med.
1980;
10
188-191
- 8
Dussaix E, Le Touzé P, Tardieu M.
Neuropathie de plexus brachial compliquant une mononucléose infectieuse chez un infant
de 18 mois.
Arch F Pediatr.
1986;
43
129-130
- 9
Gabreëls-Festen A A, Gabreëls F J, Joosten E M, Vingerhoets H M, Renier W O.
Hereditary neuropathy with liability to pressure palsies in childhood.
Neuropediatrics.
1992;
23
138-143
- 10
Gabriel S R, Thometz J G, Jaradeh S.
Septic arthritis associated with brachial plexus neuropathy. A case report.
J Bone Joint Surg Am.
1996;
78
103-105
- 11
Kennedy M, Molloy M.
Brachial plexus neuropathy in a gymnast associated with chicken pox.
Br J Sp Med.
1989;
23
226
- 12
Magee K R, DeJong R N.
Paralytic brachial neuritis. Discussion of clinical features with review of 23 cases.
JAMA.
1960;
174
1258-1262
- 13
Martin G I, Weintraub M I.
Brachial neuritis and seventh nerve palsy - a rare hazard of DTP vaccination.
Clin Pediatr.
1973;
12
506-507
- 14
Martin W A, Kraft G H.
Shoulder girdle neuritis: a clinical and electrophysiological evaluation.
Milit Med.
1974;
74
21-25
- 15
Masson P, Rigot A, Cecile W.
Névralgie brachiale amyotrophiante au decours d'un adénophlegmon cervical à pyogènes.
Arch Pédiatr.
1994;
1
735-737
- 16
McCarthy D W, Qualman S J, Rudman D T, Wiet G J, Besner G E.
Herpetic tracheitis and brachial plexus neuropathy in a child with burns.
J Burn Care Rehabil.
1999;
20
377-381
- 17
Sadleir L G, Connolly M B.
Acquired brachial plexus neuropathy in the neonate: a rare presentation of late-onset
group-B streptococcal osteomyelitis.
Dev Med Child Neurol.
1998;
40
496-499
- 18
Schott G D.
A chronic and painless form of idiopathic brachial plexus neuropathy.
J Neurol Neurosurg Psychiatry.
1983;
46
555-557
- 19
Serratrice G, Baudoin D, Pouget J, Blin O, Guieu R.
Formes typiques et atypiques de névralgie amyotrophiante de l'épaule: 86 cas.
Rev Neurol.
1992;
148
47-50
- 20
Shaywitz B A.
Brachial plexus neuropathy in childhood.
J Pediatr.
1975;
86
913-915
- 21
To W C, Traquina D N.
Neuralgic amyotrophy presenting with bilateral vocal cord paralysis in a child: a
case report.
Int J Pediatr Otorhinolaryngol.
1999;
48
251-254
- 22
Tonali P, Uncini A, Di Pasqua P G.
So-called neuralgic amyotrophy: clinical features and long-term follow-up.
Ital J Neurol Sci.
1983;
4
431-437
- 23
Tsairis P, Dyck P J, Mulder D W.
Natural history of brachial plexus neuropathy. Report on 99 patients.
Arch Neurol.
1972;
27
109-117
- 24
Wang Y C, Lin F K, Hung K L, Wu D Y.
Brachial plexus neuropathy secondary to septic arthritis and osteomyelitis: report
of two cases.
Chung Hua Min Kuo Hsiao Erh Ko I Hsueh Hui Tsa Chih.
1994;
35
449-454
- 25 Wilbourn A J.
Brachial plexus disorders. Dyck PJ, Thomas PK, Griffin JW, Low PA, Poduslo JF Peripheral Neuropathy. 3rd ed. Philadelphia;
WB Saunders 1993: 933-934
- 26
Young R SK, Hawkes D L.
Pseudopseudoparalysis.
Am J Dis Child.
1982;
137
504
- 27
Zeharia A, Mukamel M, Frishberg Y, Weitz R, Mimouni M.
Benign plexus neuropathy in children.
J Pediatr.
1990;
116
276-278
M. D. N. van Alfen
Neuromuscular Centre Nijmegen
Institute of Neurology
University Medical Centre Nijmegen
PO Box 9101
6500 HB Nijmegen
The Netherlands
Email: nvalfen@knmg.nl