II. Epidemiology
- Incidence: 1.64 per 100,000 (rare)
- Age: 30 to 70 years old
III. Etiology
- Post-Viral (reported in 25% of cases)
- Allergic Reaction
- Post-Trauma
- Postoperative
- Pitching
- Backpacker palsy
- Hikers or military carrying a heavy backpack for hours
- Results in compression and traction at the Brachial Plexus
IV. Symptoms
- Shoulder weakness follows pain within 1 to 30 days
- Hand Paresthesias may be present
- Acute severe Shoulder Pain or arm and Neck Pain for 1-2 weeks
- Sharp, intense pain
- Worse at night
- Pain of short duration
V. Signs
VI. Diagnostics
- Electromyogram shows neurogenic atrophy
VII. Differential Diagnosis
-
Cervical Radiculopathy
- Dermatomal Distribution of deficits (non-dermatomal in Acute Brachial Neuritis)
- Spurling's Test typically positive (negative in Acute Brachial Neuritis)
- Rotator Cuff Syndrome
- Extremity Trauma
- Acute Shoulder Arthritis
- Adhesive Capsulitis
VIII. Management
- Symptomatic care
- Corticosteroids may be considered (but not consistently supported by literature)
IX. Prognosis
- Full recovery in 89% by 2-3 years
- Recurrence in up to 25%
X. References
- Delaney, Orman, Herbert in Herbert (2016) EM:Rap 16(12): 3-4
- Simon (2023) Am Fam Physician 107(5): 503-12 [PubMed]