Uncommon cervicobrachial neuralgia: about 17 cases

##plugins.themes.academic_pro.article.sidebar##

Published Jul 11, 2011
Download
pdf
Vol. 89 No. 7 (2011): Issue Jul 2011

##plugins.themes.academic_pro.article.main##

Leila Cheikhrouhou Abdelmoula
Lilia Daoud
Chiraz Ben Hadj Yahia
Raoudha Tekaya
Lilia Chaabouni
Rafik Zouari

Abstract

Background: Cervicobrachial neuralgia (CBN) is frequent in out patient clinic as well in general medicine as in rheumatology. Even though cervical disc degeneration and osteophytosis constitute the most frequent etiology of such a trouble, the practitioner must be aware of much more serious underlying cause.
Aim: To investigate the epidemiology, clinical features, aetiologies and paraclinical characteristics of uncommon CBN.
Methods: Retrospective chart review about 17 cases of uncommon CBN among the 84 cases of CBN hospitalized at the rheumatology department of the Charles Nicolle Hospital during a 16-years-period [1990-2005].
Results: There were 11 men and 6 women with a mean age of 63 years [33y-81y]. All patients presented a CBN since in average five months [2 months- 24 months]. Neck stiffness was noted in 60% of cases and a neurological impairment in 47% of cases. X-ray radiographs of cervical spine were normal in five cases. In the remaining cases, they showed lytic images (six cases), disk space narrowing with vertebral erosions (two cases) and vertebral fracture (three cases). Further investigations concluded that the CBN was due to a Pancoast’syndrome in five cases, an infectious spondylitis in three cases, cervical bone metastasis in two cases, a syringomyelia in two cases, a neuroma in one case, a thoracic outlet syndrome in one case and an erosive spondylarthropathy in a paatent presentig chronic renal failure managed by hemodialysis.
Conclusion: In comparison with common CBN, our patients presenting symptomatic CBN were characterised by an inflammatory and refractory pain. The more frequent recourse to modern imaging is justified.

Keywords:

Cervicobrachial neuralgia, X-ray computed tomography, MRI, infectious spondylitis, tumor

##plugins.themes.academic_pro.article.details##

References

  1. Ben Hadj Yahia C, Kchir MM, Chaabouni L, Zouari R. Erosive spondylarthropathy in hemodialysis. A case report. Tunis Med. 2001; 79:553-6.
  2. Chaouat Y, Ginet CI, Zecer B. Etude de 108 névralgies cervicobrachiales. Les concepts de névralgie cervico-brachiale idiopathique et de névralgie cervico brachiale cervicarthrosique. Rev Rhum 1978; 45 :111-7.
  3. Aimard G, Charles N. La névralgie cervico-brachiale . Problèmes diagnostiques en neurologie. J Neuroradiol 1992 ; 19 :149-53.
  4. Toty L, Gruenwald D, Bakdach H et al. Résultats de la chirurgie des cancers pulmonaires avec syndrome de Pancoast Tobias. Une série homogène de 76 opérés. Ann Chir Thorac Cardiovasc 1984; 38:96-100.
  5. Touboul E, Roy Camille R, Guérin RA, Léonard Ph. Tumeurs extra-durales rachidiennes métastatiques. A propos de cent trente cas. Ann Chir 1985 ; 39 :5-14.
  6. Hubault A. Névralgies cervico-brachiales. Encycl Med Chir, Paris. Appareil locomoteur, 14370 C10,9-1983.
  7. Tavernier C, Maillefert JF, Piroth C. Diagnostic et traitement des cervicalgies. Encycl Med Chir, Paris. Appareil locomoteur, 14- 365-A-10,1996,14p.
  8. Auque J, Bouzoubaa Y, Marchal Jc et al. Neurosarcome du plexus brachial révélé par des cervicobrachialgies. Neurochirurgie 1982; 28 : 425-8.
  9. Roger B, Chaise F, Delmas PF, Frija J, Laval -Jeantet M. Les paralysies et névralgies cervico-brachiales d'origine tumorale : apport de la myélographie et de la tomodensitométrie associées. Ann Radiol 1986 ; 29 :13-7.
  10. Guerin RA, Touboul E, Catache E, Bennoit P. Place de la radiothérapie et de la chimiothérapie dans le traitement du syndrome de Pancoast Tobias et des cancers de l'apex. Ann. Chir Thorac Cardiovasc,1984; 38:104-108.
  11. Reboud E, Giudicelli R, Giorgi S, Fuentes P. Traitement chirurgical des cancers broncho-pulmonaires avec envahissement pariétal Ann Chir Thorac Cardiovasc 1984;38 :102 -103.
  12. Pertuiset E. Tuberculose vertébrale de l'adulte. Encycl Med Chir, Paris, Appareil locomoteur 15-852-A-10, 1998,8p.
  13. A chouri M, Helmani S, Lakhdhar H, Naja A, Boucette M. Abord antérieur du rachis cervical dans le mal de Pott à propos de sept cas. Rev Chir Orthop1997; 83:447- 53.