RT Journal Article
SR Electronic
T1 Clinical Reasoning: A 26-Year-Old Female With Recurrent Pain, Weakness, and Atrophy in Bilateral Upper Limbs During Pregnancy and Puerperium
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 10.1212/WNL.0000000000201705
DO 10.1212/WNL.0000000000201705
A1 Tian-fang Zeng
A1 Xin Ding
A1 Dan Yang
A1 Chang-Chuan Wu
A1 Dan-Dan Xie
A1 Wen-Min Zhang
YR 2022
UL http://n.neurology.org/content/early/2022/12/15/WNL.0000000000201705.abstract
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.