ATRAUMATIC BRACHIAL PLEXOPATHY FOLLOWING INTRAVENOUS HEROIN USE

A 32-year-old man presented to the accident & emergency (A&E) departme nt complaining of an inability to use his left arm and shoulder. The p revious day he had injected heroin intravenously into his left antecub ital vein. Examination revealed signs of a left-sided brachial plexus lesion. There was no history or sign of trauma. Neurological investiga tion revealed motor and sensory loss compatible with a complete brachi al plexus lesion. He exhibited a very rare condition, asymmetrical atr aumatic brachial plexopathy, thought to result from an inflammatory ca use, which not only affects the brachial, but also other plexi or indi vidual nerves in the body and thought to be related to repeated intrav enous use of heroin. This is a condition for which there is no specifi c treatment but which usually resolves spontaneously in the absence of continuing heroin n-misuse.