Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Brachial Neuritis Medication

  • Author: Nigel L Ashworth, MBChB, MSc, FRCPC; Chief Editor: Milton J Klein, DO, MBA  more...
 
Updated: May 08, 2016
 

Medication Summary

The goal of pharmacotherapy is to reduce morbidity and prevent complications.

Next

Analgesics

Class Summary

These agents often are necessary for initial pain control.[31]

Acetaminophen (Tylenol, Panadol, Aspirin Free Anacin)

 

DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, who have been diagnosed with upper GI disease, or who are on oral anticoagulants.

Acetaminophen and codeine (Tylenol #3)

 

Indicated for the treatment of mild to moderate pain.

Hydrocodone bitartrate and acetaminophen (Vicodin ES)

 

Drug combination indicated for moderate to severe pain.

Oxycodone and acetaminophen (Percocet)

 

Drug combination indicated for the relief of moderate to severe pain. DOC for aspirin hypersensitive patients.

Previous
 
 
Contributor Information and Disclosures
Author

Nigel L Ashworth, MBChB, MSc, FRCPC Professor, Divisions of Physical Medicine and Rehabilitation and Neurology, University of Alberta Faculty of Medicine and Dentistry, Canada

Nigel L Ashworth, MBChB, MSc, FRCPC is a member of the following medical societies: Canadian Society of Clinical Neurophysiologists, Australian & New Zealand Association of Neurologists, American Association of Neuromuscular and Electrodiagnostic Medicine, British Medical Association, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Received honoraria from Allergan for speaking and teaching.

Chief Editor

Milton J Klein, DO, MBA Consulting Physiatrist, Heritage Valley Health System-Sewickley Hospital and Ohio Valley General Hospital

Milton J Klein, DO, MBA is a member of the following medical societies: American Academy of Disability Evaluating Physicians, American Academy of Medical Acupuncture, American Academy of Osteopathy, American Academy of Physical Medicine and Rehabilitation, American Medical Association, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, American Pain Society, Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

Benjamin M Sucher, DO, FAOCPMR, FAAPMR Medical Director, EMG Labs of AARA (Arizona Arthritis and Rheumatology Associates)

Benjamin M Sucher, DO, FAOCPMR, FAAPMR is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Osteopathic College of Physical Medicine and Rehabilitation, Arizona Society of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Osteopathic Association

Disclosure: Nothing to disclose.

References
  1. England JD. The variations of neuralgic amyotrophy. Muscle Nerve. 1999 Apr. 22(4):435-6. [Medline].

  2. England JD, Sumner AJ. Neuralgic amyotrophy: an increasingly diverse entity. Muscle Nerve. 1987 Jan. 10(1):60-8. [Medline].

  3. Suarez GA, Giannini C, Bosch EP, et al. Immune brachial plexus neuropathy: suggestive evidence for an inflammatory-immune pathogenesis. Neurology. 1996 Feb. 46(2):559-61. [Medline].

  4. Conway RR. Neuralgic amyotrophy: uncommon but not rare. Mo Med. 2008 Mar-Apr. 105(2):168-9. [Medline].

  5. Sathasivam S, Lecky B, Manohar R, et al. Neuralgic amyotrophy. J Bone Joint Surg Br. 2008 May. 90(5):550-3. [Medline].

  6. Pan YW, Wang S, Tian G, Li C, Tian W, Tian M. Typical brachial neuritis (Parsonage-Turner syndrome) with hourglass-like constrictions in the affected nerves. J Hand Surg Am. 2011 Jul. 36(7):1197-203. [Medline].

  7. Martinoli C, Gandolfo N, Perez MM, Klauser A, Palmieri F, Padua L, et al. Brachial plexus and nerves about the shoulder. Semin Musculoskelet Radiol. 2010 Nov. 14(5):523-46. [Medline].

  8. Lo YL, Mills KR. Motor root conduction in neuralgic amyotrophy: evidence of proximal conduction block. J Neurol Neurosurg Psychiatry. 1999 May. 66(5):586-90. [Medline]. [Full Text].

  9. Kuhlenbäumer G, Hannibal MC, Nelis E, et al. Mutations in SEPT9 cause hereditary neuralgic amyotrophy. Nat Genet. 2005 Oct. 37(10):1044-6. [Medline].

  10. Hoque R, Schwendimann RN, Kelley RE, et al. Painful brachial plexopathies in SEPT9 mutations: adverse outcome related to comorbid states. J Clin Neuromuscul Dis. 2008 Jun. 9(4):379-84. [Medline].

  11. Laccone F, Hannibal MC, Neesen J, et al. Dysmorphic syndrome of hereditary neuralgic amyotrophy associated with a SEPT9 gene mutation--a family study. Clin Genet. 2008 Sep. 74(3):279-83. [Medline].

  12. Aranyi Z, Csillik A, Devay K, et al. Ultrasonographic identification of nerve pathology in neuralgic amyotrophy: Enlargement, constriction, fascicular entwinement and torsion. Muscle Nerve. 2015 Feb 20. [Medline].

  13. MacDonald BK, Cockerell OC, Sander JW, et al. The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain. 2000 Apr. 123 ( Pt 4):665-76. [Medline]. [Full Text].

  14. van Alfen N, van Eijk JJ, Ennik T, et al. Incidence of neuralgic amyotrophy (Parsonage Turner syndrome) in a primary care setting - a prospective cohort study. PLoS One. 2015. 10 (5):e0128361. [Medline].

  15. van Alfen N, van der Werf SP, van Engelen BG. Long-term pain, fatigue, and impairment in neuralgic amyotrophy. Arch Phys Med Rehabil. 2009 Mar. 90(3):435-9. [Medline].

  16. Cup EH, Ijspeert J, Janssen RJ, Bussemaker-Beumer C, Jacobs J, Pieterse AJ, et al. Residual complaints after neuralgic amyotrophy. Arch Phys Med Rehabil. 2013 Jan. 94(1):67-73. [Medline].

  17. Stogbauer F, Young P, Kuhlenbaumer G, et al. Hereditary recurrent focal neuropathies: clinical and molecular features. Neurology. 2000 Feb 8. 54(3):546-51. [Medline].

  18. Park P, Lewandrowski KU, Ramnath S, et al. Brachial neuritis: an under-recognized cause of upper extremity paresis after cervical decompression surgery. Spine. 2007 Oct 15. 32(22):E640-4. [Medline].

  19. Kumar N, Folger WN, Bolton CF. Dyspnea as the predominant manifestation of bilateral phrenic neuropathy. Mayo Clin Proc. 2004 Dec. 79(12):1563-5. [Medline].

  20. Lahrmann H, Grisold W, Authier FJ, et al. Neuralgic amyotrophy with phrenic nerve involvement. Muscle Nerve. 1999 Apr. 22(4):437-42. [Medline].

  21. Tsao BE, Ostrovskiy DA, Wilbourn AJ, et al. Phrenic neuropathy due to neuralgic amyotrophy. Neurology. 2006 May 23. 66(10):1582-4. [Medline].

  22. Pierre PA, Laterre CE, Van den Bergh PY. Neuralgic amyotrophy with involvement of cranial nerves IX, X, XI and XII [published erratum appears in Muscle Nerve 1991 Jan;14(1):88]. Muscle Nerve. 1990 Aug. 13(8):704-7. [Medline].

  23. van Eijk JJ, Madden RG, van der Eijk AA, et al. Neuralgic amyotrophy and hepatitis E virus infection. Neurology. 2014 Feb 11. 82(6):498-503. [Medline]. [Full Text].

  24. Bazerbachi F, Haffar S, Garg SK, Lake JR. Extra-hepatic manifestations associated with hepatitis E virus infection: a comprehensive review of the literature. Gastroenterol Rep (Oxf). 2016 Feb. 4 (1):1-15. [Medline]. [Full Text].

  25. Gazioglu S, Boz C, Sari A. Magnetic resonance imaging in bilateral brachial neuritis with pure sensory involvement. Neurol Sci. 2011 Nov 24. [Medline].

  26. Vassallo G, Martland T, Forbes W, McCullagh G. A valuable non-invasive diagnostic investigation for paediatric idiopathic brachial neuritis. Dev Med Child Neurol. 2010 Oct. 52(10):966-8. [Medline].

  27. Zara G, Gasparotti R, Manara R. MR imaging of peripheral nervous system involvement: Parsonage-Turner syndrome. J Neurol Sci. 2012 Apr 15. 315(1-2):170-1. [Medline].

  28. Lieba-Samal D, Jengojan S, Kasprian G, Wober C, Bodner G. Neuroimaging of classic neuralgic amyotrophy. Muscle Nerve. 2016 Apr 13. [Medline].

  29. Flaggman PD, Kelly JJ Jr. Brachial plexus neuropathy. An electrophysiologic evaluation. Arch Neurol. 1980 Mar. 37(3):160-4. [Medline].

  30. Martin WA, Kraft GH. Shoulder girdle neuritis: a clinical and electrophysiological evaluation. Mil Med. 1974 Jan. 139(1):21-5. [Medline].

  31. McCarty EC, Tsairis P, Warren RF. Brachial neuritis. Clin Orthop Relat Res. 1999 Nov. 37-43. [Medline].

  32. van Alfen N, Huisman WJ, Overeem S, et al. Sensory nerve conduction studies in neuralgic amyotrophy. Am J Phys Med Rehabil. 2009 Apr 28. [Medline].

  33. van Alfen N, van Engelen BG, Hughes RA. Treatment for idiopathic and hereditary neuralgic amyotrophy (brachial neuritis). Cochrane Database Syst Rev. 2009 Jul 8. CD006976. [Medline].

  34. Naito KS, Fukushima K, Suzuki S, Kuwahara M, Morita H, Kusunoki S, et al. Intravenous immunoglobulin (IVIg) with methylprednisolone pulse therapy for motor impairment of neuralgic amyotrophy: clinical observations in 10 cases. Intern Med. 2012. 51(12):1493-500. [Medline].

  35. van Eijk JJ, van Alfen N, Berrevoets M, et al. Evaluation of prednisone treatment in the acute phase of neuralgic amyotrophy: an observational study. J Neurol Neurosurg Psychiatry. 2009 Mar 24. [Medline].

  36. van Alfen N, van Engelen BG. The clinical spectrum of neuralgic amyotrophy in 246 cases. Brain. 2006 Feb. 129:438-50. [Medline]. [Full Text].

  37. Magee KR, Dejong RN. Paralytic brachial neuritis. Discussion of clinical features with review of 23 cases. JAMA. 1960 Nov 5. 174:1258-62. [Medline].

  38. Parsonage MJ, Turner JW. Neuralgic amyotrophy; the shoulder-girdle syndrome. Lancet. 1948 Jun 26. 1(26):973-8. [Medline].

  39. Tsairis P, Dyck PJ, Mulder DW. Natural history of brachial plexus neuropathy. Report on 99 patients. Arch Neurol. 1972 Aug. 27(2):109-17. [Medline].

  40. Turner JW, Parsonage MJ. Neuralgic amyotrophy (paralytic brachial neuritis); with special reference to prognosis. Lancet. 1957 Aug 3. 273(6988):209-12. [Medline].

  41. van Alfen N. The neuralgic amyotrophy consultation. J Neurol. 2007 Jun. 254(6):695-704. [Medline].

  42. Walker M, Zunt JR, Kraft GH. Brachial neuropathy after immunosuppression and stem cell transplantation for multiple sclerosis. Mult Scler. 2005 Feb. 11(1):90-1. [Medline].

Previous
Next
 
The patient is a 43-year-old farmer, shown 6 months after presenting with severe right shoulder pain and weakness. Note severe wasting of the right infraspinatus and deltoid and winging of the scapula.
Same patient as above. Note again severe supraspinatus and infraspinatus wasting on the right.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.