Neuralgic amyotrophy is sometimes also known as brachial plexus neuropathy.
It has a particularly specific presentation:
- severe pain in shoulder
- followed by weakness and atrophy of muscles in arms
This presentation alone in an MRCP question should point you towards neuralgic amyotrophy being the answer. Other clues which would suggest this diagnosis include:
- preceeded by a URTI
- decreased or absent reflexes
- sensory abnormalities
Rarely the diaphragm may also be affected.
There is a risk of shoulder joint subluxation or winging of the scapula.
This link takes you to an image of what just basic neuralgic amyotrophy can look like.
In general it resolves spontaneously in a few months, and treatment is conservative.
After that interesting interlude, lets do battle with the porphyrias...
