Zsuzsanna Arányi1, Anita Csillik1, Katalin Dévay2, Maja Rosero2, Péter Barsi3, Josef Böhm4, Thomas Schelle5. 1. Department of Neurology, MTA-SE NAP B Peripheral Nervous System Research Group, Semmelweis University, Balassa u. 6, Budapest, 1083, Hungary. 2. Department of Traumatology, Szt. István and László Hospital, Budapest, Hungary. 3. MRI Research Center, Semmelweis University, Budapest, Hungary. 4. Department of Neurology, Kreiskrankenhaus Freiberg, Freiberg, Germany. 5. Department of Neurology, Städtisches Klinikum Dessau, Dessau, Germany.
Abstract
INTRODUCTION: The aim of this study was to characterize the ultrasonographic findings on nerves in neuralgic amyotrophy. METHODS: Fourteen patients with neuralgic amyotrophy were examined using high-resolution ultrasound. RESULTS: Four types of abnormalities were found: (1) focal or diffuse nerve/fascicle enlargement (57%); (2) incomplete nerve constriction (36%); (3) complete nerve constriction with torsion (50%; hourglass-like appearance); and (4) fascicular entwinement (28%). Torsions were confirmed intraoperatively and were seen on the radial nerve in 85% of patients. A significant correlation was found between no spontaneous recovery of nerve function and constriction/torsion/fascicular entwinement (P = 0.007). CONCLUSION: Ultrasonographic nerve pathology in neuralgic amyotrophy varies in order of severity from nerve enlargement to constriction to nerve torsion, with treatment ranging from conservative to surgical. We postulate that the constriction caused by inflammation is the precursor of torsion and that development of nerve torsion is facilitated by the rotational movements of limbs.
INTRODUCTION: The aim of this study was to characterize the ultrasonographic findings on nerves in neuralgic amyotrophy. METHODS: Fourteen patients with neuralgic amyotrophy were examined using high-resolution ultrasound. RESULTS: Four types of abnormalities were found: (1) focal or diffuse nerve/fascicle enlargement (57%); (2) incomplete nerve constriction (36%); (3) complete nerve constriction with torsion (50%; hourglass-like appearance); and (4) fascicular entwinement (28%). Torsions were confirmed intraoperatively and were seen on the radial nerve in 85% of patients. A significant correlation was found between no spontaneous recovery of nerve function and constriction/torsion/fascicular entwinement (P = 0.007). CONCLUSION: Ultrasonographic nerve pathology in neuralgic amyotrophy varies in order of severity from nerve enlargement to constriction to nerve torsion, with treatment ranging from conservative to surgical. We postulate that the constriction caused by inflammation is the precursor of torsion and that development of nerve torsion is facilitated by the rotational movements of limbs.
Authors: Johannes H Bannasch; Benjamin Berger; Claus-Peter Schwartkop; Marco Berning; Oliver Goetze; Marcus Panning; Miriam Fritz-Weltin; George Trendelenburg; Mathias Gelderblom; Marc Lütgehetmann; Fridrike Stute; Thomas Horvatits; Meike Dirks; Christoph Antoni; Patrick Behrendt; Sven Pischke Journal: Pathogens Date: 2021-05-30