First-Hand Experience

Letter to the Editor Neuralgic Amyotrophy by Dr. med. Johannes Fabian Holle, Prof. Dr. med. Volker Limmroth, Prof. Dr. med. Wolfram Windisch, and Dr. med. Maximilian Zimmermann in issue 15/2024

I am grateful for the publication of the review article on neuralgic amyotrophy by Holle et al. As the authors pointed out, the evidence about treatment is scant (1). As someone who was diagnosed with neuralgic amyotrophy in the right shoulder and upper arm region, I have first-hand experience with this. I’m afraid the article did not provide—in addition to mentioning a physiotherapeutic intervention with a focus on movement technique—any reference to physiotherapy for pain affecting muscles, fascia, and ligaments that occurs during the course of the condition and is likely to be based on incorrect movements and reuptake of muscular exercise once the paresis is declining, as well as the option of functional electrostimulation of affected muscle groups to prevent or limit muscular atrophy. In light of recent events I also wish to point out that, as in my own case, Covid-19 has been described as an immunological trigger or neuralgic amyotrophy and should be considered as a differential diagnosis in severe localized muscle pain after infection. Timely neurological diagnosis and treatment with corticosteroids, as well as consistent physiotherapy for 12 months, supported by functional electrostimulation, helped me regain some 60% of my previous strength in the affected muscle groups. I wish the authors the best of luck in conducting the planned studies into a better understanding of the disease.

DOI: 10.3238/arztebl.m2024.0218

Prof. Dr. med. Sven Anders-Lohner, MME

Institut für Rechtsmedizin

Universitätsklinikum Hamburg-Eppendorf

References

1. Holle JF, Limmroth V, Windisch W, Zimmermann M: Neuralgic amyotrophy: a commonly overlooked cause of acute shoulder pain. Dtsch Arztebl Int 2024; 121: 483–9