Tags

Type your tag names separated by a space and hit enter

Post-operative emergence of acute brachial neuritis following posterior cervical laminectomy with fusion: A case report and review of the literature.
Int J Surg Case Rep 2019; 65:197-200IJ

Abstract

INTRODUCTION

Idiopathic brachial plexus neuritis or neuralgic amyotrophy is a rare neurological condition whose true etiology currently remains unknown. Epidemiologically, the incidence of this condition is exceptionally rare with only 1.6 cases for every 100,000 people (Turner and Parsonage, 1987). Symptoms present an initial acute and sudden pain to the shoulder girdle and upper arm which is followed by a sense of profound weakness and numbness to the upper arm (Parsonage and Turner, 1948). Localized neuropathy within the arm-pit region may also be presented. The pain often exacerbates upon movement of the shoulder. Due to the anatomic location affected and the nature of the clinical symptoms presented, accurate diagnosis of brachial plexus neuritis poses a challenging diagnostic task for physicians due to remarkably similar symptoms expressed by differential diagnoses.

PRESENTATION OF CASE

Here, we report the case of a 55-year-old woman who underwent surgery entailing cervical laminectomy with instrumented fusion. She presented with postoperative symptoms of severe pain in the left arm with significant weakness within 24 h after surgery. A diagnosis of brachial plexus neuritis was made based on the symptoms presented and upon review of imaging scans.

DISCUSSION

After a six-month follow-up visit, the patient recovered from the brachial neuritis but has residual numbness in the hand. The presentation of this case serves to transmit three fundamental purposes. First, this case serves to establish an intriguing possible association of the post-surgical period of cervical laminectomy with acute brachial neuritis and signifies the importance post-operative linkage with brachial neuritis in general. Second, this case also highlights the importance of close clinical monitoring of patients with unique symptoms within the postoperative follow-up period to ensure successful improvement and accurate diagnosis.

CONCLUSION

As an underdiagnosed and relatively obscure condition, this case serves as an imperative reference for physicians to illuminate differential diagnosis of similar symptomatic conditions and also to promote knowledge of brachial plexus neuritis which can lead to an early and precise diagnosis.

Authors+Show Affiliations

University of South Florida, Tampa, FL, United States. Electronic address: rajp1@mail.usf.edu.Department of Clinical Biomedical Sciences, Florida Atlantic University, Boca Raton, FL, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31726257

Citation

Patel, Raj H., and Rishi N. Sheth. "Post-operative Emergence of Acute Brachial Neuritis Following Posterior Cervical Laminectomy With Fusion: a Case Report and Review of the Literature." International Journal of Surgery Case Reports, vol. 65, 2019, pp. 197-200.
Patel RH, Sheth RN. Post-operative emergence of acute brachial neuritis following posterior cervical laminectomy with fusion: A case report and review of the literature. Int J Surg Case Rep. 2019;65:197-200.
Patel, R. H., & Sheth, R. N. (2019). Post-operative emergence of acute brachial neuritis following posterior cervical laminectomy with fusion: A case report and review of the literature. International Journal of Surgery Case Reports, 65, pp. 197-200. doi:10.1016/j.ijscr.2019.07.065.
Patel RH, Sheth RN. Post-operative Emergence of Acute Brachial Neuritis Following Posterior Cervical Laminectomy With Fusion: a Case Report and Review of the Literature. Int J Surg Case Rep. 2019 Jul 25;65:197-200. PubMed PMID: 31726257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-operative emergence of acute brachial neuritis following posterior cervical laminectomy with fusion: A case report and review of the literature. AU - Patel,Raj H, AU - Sheth,Rishi N, Y1 - 2019/07/25/ PY - 2019/04/04/received PY - 2019/07/14/revised PY - 2019/07/18/accepted PY - 2019/11/15/pubmed PY - 2019/11/15/medline PY - 2019/11/15/entrez KW - Brachial neuritis KW - Cervical laminectomy KW - Neuralgic amyotrophy KW - Neuropathy KW - Post-surgical KW - Shoulder pain SP - 197 EP - 200 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 65 N2 - INTRODUCTION: Idiopathic brachial plexus neuritis or neuralgic amyotrophy is a rare neurological condition whose true etiology currently remains unknown. Epidemiologically, the incidence of this condition is exceptionally rare with only 1.6 cases for every 100,000 people (Turner and Parsonage, 1987). Symptoms present an initial acute and sudden pain to the shoulder girdle and upper arm which is followed by a sense of profound weakness and numbness to the upper arm (Parsonage and Turner, 1948). Localized neuropathy within the arm-pit region may also be presented. The pain often exacerbates upon movement of the shoulder. Due to the anatomic location affected and the nature of the clinical symptoms presented, accurate diagnosis of brachial plexus neuritis poses a challenging diagnostic task for physicians due to remarkably similar symptoms expressed by differential diagnoses. PRESENTATION OF CASE: Here, we report the case of a 55-year-old woman who underwent surgery entailing cervical laminectomy with instrumented fusion. She presented with postoperative symptoms of severe pain in the left arm with significant weakness within 24 h after surgery. A diagnosis of brachial plexus neuritis was made based on the symptoms presented and upon review of imaging scans. DISCUSSION: After a six-month follow-up visit, the patient recovered from the brachial neuritis but has residual numbness in the hand. The presentation of this case serves to transmit three fundamental purposes. First, this case serves to establish an intriguing possible association of the post-surgical period of cervical laminectomy with acute brachial neuritis and signifies the importance post-operative linkage with brachial neuritis in general. Second, this case also highlights the importance of close clinical monitoring of patients with unique symptoms within the postoperative follow-up period to ensure successful improvement and accurate diagnosis. CONCLUSION: As an underdiagnosed and relatively obscure condition, this case serves as an imperative reference for physicians to illuminate differential diagnosis of similar symptomatic conditions and also to promote knowledge of brachial plexus neuritis which can lead to an early and precise diagnosis. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/31726257/Post-operative_emergence_of_acute_brachial_neuritis_following_posterior_cervical_laminectomy_with_fusion:_A_case_report_and_review_of_the_literature L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(19)30447-X DB - PRIME DP - Unbound Medicine ER -