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November 01, 1996; 47 (5) Articles

Postpartum neuralgic amyotrophy

Richard J. Lederman, Asa J. Wilbourn
First published November 1, 1996, DOI: https://doi.org/10.1212/WNL.47.5.1213
Richard J. Lederman
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Asa J. Wilbourn
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Citation
Postpartum neuralgic amyotrophy
Richard J. Lederman, Asa J. Wilbourn
Neurology Nov 1996, 47 (5) 1213-1219; DOI: 10.1212/WNL.47.5.1213

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Abstract

We report 11 women with at least one episode of neuralgic amyotrophy occurring postpartum.One woman had three episodes - two postpartum and a third occurring after minor foot surgery. Two others had a second episode, one following a first trimester spontaneous abortion and one after a viral syndrome. Pain followed delivery from as little as 1 to 2 hours to up to 2 weeks and usually lasted from a few weeks to several months. Weakness, if delayed, followed onset of pain by 2 or 3 days up to 5 weeks. Four of the episodes were bilateral. Clinical weakness and electrodiagnostic findings varied widely, from involvement of a single peripheral nerve (e.g., long thoracic, anterior interosseous) to multiple bilateral proximal and distal nerves. Functional recovery was excellent (90 to 100%) in 8 of the 10 with adequate follow-up, requiring as little as 2 weeks or up to 3 years. Two women have moderate persisting weakness (both bilateral) at 3 years and 2 years. Five patients went on to subsequent deliveries without recurrence of neuralgic amyotrophy. Only one of the 11 women had a history suggesting familial neuralgic amyotrophy, a disorder generally thought to be associated particularly with postpartum episodes. Although the etiology of postpartum neuralgic amyotrophy remains unknown, an immunologic mechanism is suspected. Focal demyelination may play a role in some, but clearly axonal degeneration is predominant in the majority.

NEUROLOGY 1996;47: 1213-1219

  • Copyright 1996 by Advanstar Communications Inc.
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