Pathophysiology and Diagnosis of Neuralgic Amyotrophy

Neuralgic amyotrophy (NA) is a multifactorial disorder characterized by the sudden onset of severe shoulder pain followed by patchy weakness and muscle atrophy.Its pathophysiology is thought to involve a combination of genetic susceptibility, immune-mediated inflammation, and biomechanical stress.Diagnosis requires an integrated approach combining clinical assessment, electrodiagnostic testing, and high-resolution imaging.MRI and ultrasonography provide complementary information, allowing visualization of nerve swelling, perineural edema, denervation changes in affected muscles, and detailed morphology of peripheral nerves.Electrodiagnostic studies help differentiate NA from other neuromuscular or musculoskeletal disorders.Although no standardized treatment protocol has been established, most patients benefit from multimodal pain control and individualized rehabilitation.Immunomodulatory therapies such as corticosteroids or intravenous immunoglobulin may be considered in patients with prominent inflammatory features, while surgical neurolysis is reserved for cases with imaging-confirmed nerve constriction showing poor recovery after conservative treatment.Understanding the diverse mechanisms underlying NA and applying a multimodal diagnostic approach are essential for selecting appropriate therapeutic strategies and optimizing clinical outcomes.