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首页> 外文期刊>Journal of Hand Surgery. American Volume >Typical brachial neuritis (Parsonage-Turner syndrome) with hourglass-like constrictions in the affected nerves.
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Typical brachial neuritis (Parsonage-Turner syndrome) with hourglass-like constrictions in the affected nerves.

机译：典型的臂状神经炎（Parsonage-Turner综合征），受累神经沙漏状收缩。

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摘要

PURPOSE: To report on 5 patients who had acute brachial neuritis (Parsonage-Turner syndrome) with hourglass-like constriction in the affected nerves. METHODS: We retrospectively reviewed 5 patients who were treated in our department from December 2003 to December 2008. Acute, intense pain around the shoulder girdle and upper arm was the first symptom and was followed by muscle weakness and atrophy. Clinical and EMG examinations showed involvement of 2 or more nerves in the affected extremity. Those severely affected nerves that had no response to conservative treatment were explored, and an hourglass-like constriction was identified. Neurolysis was performed at the sites of constrictions in 2 radial nerves and 1 median nerve. The constricted portion was resected, and direct coaptation was performed in 1 radial nerve and 1 musculocutaneous nerve. The constricted portion was resected, and nerve graft was performed in 2 radial nerves and 1 median nerve. RESULTS: All patients were followed up for 24 to 84 months after surgery. Of 3 nerves treated with external neurolysis, all attained full recovery. Of 2 nerves treated with resection and neurorrhaphy, 1 attained full recovery, and the other had an incomplete recovery. Of 3 nerves treated with resection and nerve graft, 1 (4-cm nerve graft) attained full recovery, and 2 (4-cm and 13-cm nerve graft, respectively) had incomplete recovery. CONCLUSIONS: The site of nerve lesion of brachial neuritis was not necessarily within the brachial plexus. Our finding of hourglass-like constrictions in individual peripheral nerves suggest that multifocal involvement of terminal branch lesions may underlie the complex patterns of paralysis often encountered clinically. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
机译：目的：报告5例患有急性臂神经炎（Parsonage-Turner综合征）并在受累神经中出现沙漏状收缩的患者。方法：我们回顾性回顾了2003年12月至2008年12月在我科接受治疗的5例患者。肩带和上臂周围的剧烈剧烈疼痛是首发症状，其次是肌肉无力和萎缩。临床和EMG检查显示受影响的肢体累及2条或更多条神经。探索了那些对保守治疗无反应的严重受影响的神经，并发现了沙漏状的收缩。在2根radial神经和1根正中神经的收缩部位进行神经溶解。切除狭窄的部分，并在1条radial神经和1条肌皮神经中进行直接接合。切除狭窄部分，并在2条radial神经和1条正中神经进行神经移植。结果：所有患者术后均获随访24〜84个月。在接受外部神经溶解治疗的3条神经中，所有神经均已完全恢复。接受切除和神经腹泻治疗的2条神经中，有1条完全恢复，另一条恢复不完全。在接受切除和神经移植的3条神经中，有1条（4厘米的神经移植物）完全恢复，有2条（分别为4厘米和13厘米的神经移植物）恢复不完全。结论：臂神经炎的神经病变部位不一定位于臂丛内。我们在单个周围神经中发现的沙漏状收缩表明，末端分支病变的多灶性受累可能是临床上经常遇到的麻痹的复杂模式的基础。研究类型/证据水平：预后IV。

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