CHRONIC RELAPSING BRACHIAL-PLEXUS NEUROPATHY WITH PERSISTENT CONDUCTION BLOCK

Idiopathic brachial plexus neuropathy (BPN) is an immunemediated disor der characterized by an acute onset of painful weakness in one or both upper extremities. The course is usually monophasic with gradual impr ovement over months; however, occasionally BPN can recur. Electrophysi ologic studies suggest the pathogenesis is primarily axonal in the maj ority of cases. We descibe an unusual case of BPN in which the patient had a chronic and relapsing course of painless weakness associated wi th conduction blocks and other electrophysiologic features of demyelin ation across the brachial plexus. The patient improved following treat ment with intravenous immunoglobulin. The neuropathy falls within the spectrum of chronic inflammatory demyelinating polyneuropathy and mult ifocal motor neuropathy. (C) 1997 John Wiley & Sons, Inc.