Letters to the Editor
In Reply
Our heartfelt thanks for your constructive comments on our article on neuralgic amyotrophy. Among others you point out the lack of reference to “physiotherapy for pain affecting muscles, fascia, and ligaments […].” We attempted to do justice to this aspect in as far as we mentioned “evidence […] specific physiotherapeutic interventions with a focus on movement technique” in the treatment of secondary musculoskeletal pain syndrome (1). Because of specified space constraints, we were not able to provide a more differentiated explanation of the physiotherapeutic and rehabilitative aspects of treatment, but these can be found in (2).
Furthermore, you mentioned that COVID-19 has been described as a trigger of neuralgic amyotrophy. That is obviously correct as well as important. In the article we mentioned that “in principle […] many immunostimulatory factors are potential triggers of an NA attack” and these can include “infection, vaccines, immunotherapy (such as interferons and immune checkpoint inhibitors), surgical procedures, pregnancy and childbirth, trauma, and mental stress.” Listing all pathogens/triggers mentioned in the literature would have exceeded the scope of the article, which is why we discussed hepatitis E virus as a rather specific trigger of NA.
DOI: 10.3238/arztebl.m2024.0219
On behalf of the authors
Dr. med. Johannes Fabian Holle
Klinik für Neurologie, Kliniken der Stadt Köln gGmbH
Fakultät für Gesundheit/Department für Humanmedizin
Universität Witten/Herdecke, Köln
johannes.holle@uni-wh.de
Conflict of interest statement
The authors of both contributions declare that no conflict of interest exists.
| 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 VOLLTEXT CrossRef MEDLINE PubMed Central |
| 2. | Ijspeert J, Janssen RM, Murgia A, et al.: Efficacy of a combined physical and occupational therapy intervention in patients with subacute neuralgic amyotrophy: a pilot study. NeuroRehabilitation 2013; 33: 657–65 CrossRef MEDLINE |
