Anterior Interosseous Nerve Syndrome vs Brachial Plexus Neuritis

[GoldFever]

I took a severe fall on my shoulder and immediately developed numbness down my arm (C-6 path). Pain was throughout my shoulder, especially behind (where I fell), and down my arm. Two months later, after in intense physical therapy session on the back side of my shoulder, I developed anterior interosseous nerve syndrome; the classic loss of thumb and index finger control. The orthopedic doctor performed rotator cuff surgery (no damage found). Physical therapy only worsens the condition. Nine months later, I still cannot totally lift my arm without pain an have loss much muscle.

I am curious about any relationship between Anterior Interosseous Nerve Syndrome and Brachial Plexus Neuritis. Can Brachial Plexus Neuritis result due to an injury? Can it cause anterior interosseous nerve syndrome? Is their any medical treatment for Brachial Plexus Neuritis? Is there any evidence that anterior interosseous nerve syndrome will subside without surgery?

[CCF-Neuro-M.D.-JT]

Brachial plexus neuritis is also known as neuralgic amyotrophy or Parsonage Turner syndrome which has been known to involve many of the nerves of the brachial plexus, including the anterior interosseus nerve (AION). No one is quite sure what the actual cause of it is, but it is thought to be an inflammatory condition related to the immune system. The disease has been associated with a preceding infection (just about any kind), surgery, immunizations, and has also been found in families, but NOT trauma. In fact, the diagnosis should only be made in the absence of trauma. Although there is no known treatment for the disease (which resolves in most patients in 1-3 months, sometimes longer) we have seen some improvement at the Cleveland CLinic with IVIg, an immune modulating medication.

As for your particular case, I am quite wary about your diagnosis and strongly recommend you see a neurologist and possibly get an EMG to help truly localize the problem. You could possibly have a brachial plexus injury (which is in the area of your injury) rather than an AION (as this is in the elbow region). You may even need an MRI of your cervical spine to make sure there is not a herniated disc pushing on your nerves or shoulder depending on the exam. GOod luck.

[snowgoer]

I read with interest your situation. I too suffered what the MD's believed to be brachial neuritis following rotator cuff surgery. I suffered through much pain and atrophy of the shoulder muscles, not to mention loss of activities I enjoyed. EMG's were done which seemed to point to this diagnosis, but many months later (13) there was no improvement. I recently had a neurography study done which showed a "sharp focal kink" in my suprascapular nerve. It is too late now to reverse any of the damage done to my muscles due to deinervation, and had I had this study done sooner I could be back to normal now. I urge you to have a study such as this done, as well as an MRI of your cervical spine to make sure no nerve impingement there is occurring. I wish you the best of luck.

[Siggy00]

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Sig..

[miss martha]

My son is nine years old and has had no use of his right arm hand and shoulder since being diagnosed with post-viral brachial neuritis in December. He had pneumonia in October and when that cleared up (end of October) he began complaining of severe (level 10 of 10) pain in his right arm. After a week of Neurontin in early December the pain lessened significantly, but he has not been able to use the hand. He is right handed and this has disrupted his school  year tremendously. He has lost muscle mass in his right shoulder and has developed a ganglia on the inside of his right wrist. An MRI in December of the cervical spine was normal. An EMG in February showed active damage still occuring in the brachial plexus region. He has been in PT 2-3 times a weak since December, mainly tobuild strength. However, it is very very difficult to motivate him! My husband and I are now looking for adaptive technologies to help him use the right hand until the nerves regenerate. He will be evaluated by a hand therapist next week. We live near Philadelphia PA and he is being seen by a neurologist at Children's Hospital.

Martha

[snowgoer]

Sorry to hear about your son. It does sound like he has what I have researched about brachial neuritis, so hopefully this will improve soon. Thought you might be interested in this forum I have found regarding brachial plexus injuries. There are several suggestions there and many people with first hand knowledge about what your son is going through. It can be found at:

     http://www.ubpn.org/messageboard/index.jsp

Good luck and best wishes!