Motor root conduction in neuralgic amyotrophy: evidence of proximal conduction block
Clinical
Neurophysiology Unit, University Department of Clinical Neurology, The
Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK
Correspondence to: Professor K R Mills, Clinical Neurophysiology Unit, University Department of Clinical Neurology, The Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK. Telephone 0044 1865 224709; fax 0044 1865 790493.
Received 6
August 1998 and in revised form 12 November 1998;
Accepted 20 November 1998
OBJECTIVE
To determine
the presence and role of proximal conduction block in neuralgic amyotrophy.
METHODSPercutaneous
electrical stimulation of cervical roots and brachial plexus was
employed in eight patients with neuralgic amyotrophy. Root to Erb's
point compound muscle action potential amplitude ratios for abductor
digiti minimi, extensor digitorum communis, biceps, and deltoid muscles
were compared with results obtained from 10 healthy controls.
RESULTSConduction
block in the nerve to one muscle was found in three of eight patients
(38%) suggesting focal proximal demyelination. Repeat studies showed
axonal degeneration, resolution, and persistence of conduction block in
these three patients respectively.
CONCLUSIONFocal
conduction block plays a significant part in the pathogenesis of
neuralgic amyotrophy, which is generally regarded as an axon loss
process. Therapeutic intervention should be directed to patients with
persistent conduction block, with the aim of eradicating the block and
possibly minimising subsequent axon loss.
Keywords: neuralgic amyotrophy; proximal stimulation; conduction block
© 1999 by Journal of Neurology, Neurosurgery, and Psychiatry
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