PT  - JOURNAL ARTICLE
AU  - Tian-fang Zeng
AU  - Xin Ding
AU  - Dan Yang
AU  - Chang-Chuan Wu
AU  - Dan-Dan Xie
AU  - Wen-Min Zhang
TI  - Clinical Reasoning: A 26-Year-Old Female With Recurrent Pain, Weakness, and Atrophy in Bilateral Upper Limbs During Pregnancy and Puerperium
AID  - 10.1212/WNL.0000000000201705
DP  - 2022 Dec 15
TA  - Neurology
PG  - 10.1212/WNL.0000000000201705
4099  - http://n.neurology.org/content/early/2022/12/15/WNL.0000000000201705.short
4100  - http://n.neurology.org/content/early/2022/12/15/WNL.0000000000201705.full
AB  - We present a case of a 26-year-old female with recurrent episodes of severe pain, weakness, and atrophy in her bilateral upper extremities during pregnancy and puerperium. She reported two similar episodes at ages five and ten, after which she fully recovered. On examination, we observed significant atrophy in her bilateral upper extremity muscles with decreased strength. Needle electromyography (EMG) revealed neurogenic damage in her bilateral upper limbs. The patient's clinical manifestations and auxiliary examination suggested a brachial plexopathy. Metabolic and immune factors that may occur during pregnancy and puerperium were evaluated. We also screened for paraneoplastic, neoplastic, and genetic factors. Finally, a hereditary form of disease was considered. This case emphasizes the importance of early diagnosis and avoidance of triggers.