What is neuralgic amyotrophy?
Neuralgic amyotrophy (NA) is a disorder involving nerve pain and muscle wasting. In the Netherlands, NA is often referred to as 'neuralgic shoulder amyotrophy' or 'Parsonage-Turner syndrome'.
Episodes of severe pain
Neuralgic amyotrophy is characterized by episodes of severe pain in one or both shoulders and arms. After a few hours to several days, the pain is followed by weakness and wasting of the muscles in the affected area. It is caused by inflammation of the nerve plexus in the arm (brachial plexus brachialis), a branching network of intersecting nerves. The pain may last for a few weeks and is often unbearable. The muscle weakness causes difficulty with arm movements such as stretching, working above shoulder height, opening bottles or jar lids or holding a pen. Sometimes the shoulder blade sticks out from the back like a wing (scapula alata). Recovery of the nerves, and restoration of muscle strength and endurance, usually takes several months to a few years and is often incomplete. Many patients are left with chronic symptoms of pain and fatigue in the affected shoulder and arm.
Hereditary or non-hereditary
Two forms of NA are known:
- Hereditary NA (hereditary neuralgic amyotrophy or HNA).
- Non-hereditary NA (idiopathic neuralgic amyotrophy, Parsonage-Turner or INA syndrome).
The idiopathic form occurs about ten times more often than the hereditary form. According to estimates, NA is diagnosed in about 17,000 people per year in the Netherlands.
Examples of shoulder movement problems
In the video clips below, you can see several examples of shoulder movement problems caused by NA:
Treatments and examinations
Treatment of diaphragmatic paralysis in NA can be done by self-administered measures, overnight ventilation, or (if there is no recovery after 3-4 years) reefing the diaphragm.
to the treatment
The Radboudumc has several consultation hours for patients with (possible) neuralgic amyotrophy or other injuries of the nerves in the shoulder and arm.
to the treatment