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J Neurol Neurosurg Psychiatry. 1999 May; 66(5): 586–590. | PMCID: PMC1736345 |
Motor root conduction in neuralgic amyotrophy: evidence of
proximal conduction block Y. Lo and K. Mills Clinical Neurophysiology Unit, University Department of Clinical Neurology, The Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK. OBJECTIVE—To determine
the presence and role of proximal conduction block in neuralgic amyotrophy.
METHODS—Percutaneous
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.
RESULTS—Conduction
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.
CONCLUSION—Focal
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.
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