Acute brachial radiculitis / by J.W. Aldren Turner.

  • Turner, J. W. Aldren (J. William Aldren), 1864-1945.
Date:
[1944]
Catalogue details

Licence: Public Domain Mark

Credit: Acute brachial radiculitis / by J.W. Aldren Turner. Source: Wellcome Collection.

    1/6
    Reprinted .from the British Medical Journal November 4, 1944, vol. ii, p. 592 ACUTE BRACHIAL RADICULITIS BY J. W. ALDREN TURNER, D.M., M.R.C.P. TjMajor, R.A.M.C.; Command Neurologist Spillane (1943) has drawn attention to the comparative frequency of cases of neuritis of the nerves around the shoulder girdle in his experience with the M.E.F. Cases also occur in which the incidence is predominantly on the roots of the brachial plexus rather than on the peripheral nerves, and combinations of these conditions are seen in other patients. This paper is based on 36 cases—24 personally observed in various stages of the disease and 12 seen by Major Philip Buckley, R.A.M.C. The essential clinical picture is a simple one : severe pain starts across the back of the shoulder and radiates down the outer side of the arm and sometimes on to the upper part of the chest; the pain remains severe for a few days and then weakness of the shoulder develops, sometimes accom¬ panied by numbness. As the paralysis appears the severe pain usually passes off and is replaced by a dull ache, the paralysis persisting. Illustrative Case History An R.A.F. corporal aged 33 was admitted to hospital on Sept. 15, 1942, with the history that six weeks previously he had developed very severe pain across the back of both shoulder-blades, which radiated down the outer side of the right arm and forearm; the severe pain persisted for about five days and was then replaced by a dull ache. On the third day of the severe pain he noted con¬ siderable weakness of both arms, but especially the right, and this weakness had persisted unchanged. There were no general symptoms of malaise or fever at the onset of the illness, and his past history was uneventful except for attacks of migraine. On examination he had winging of the left scapula due to paralysis of the serratus magnus. In the right arm there was con¬ siderable wasting of the spinati, deltoid, biceps, supinator longus, and the clavicular head of the pectoralis major. There was minimal voluntary power in the supinator longus, while the other wasted muscles were weak; the biceps and supinator jerks were absent, and the triceps jerk just present. On sensory testing there was impair- roent of cutaneous sensibility down the outer side of the right arm and forearm in the distribution of C.5 and 6 segments. There were no other abnormal neurological signs. The W.R. was negative. The C.S.F. was under pressure of 150 mm. and there was no block on jugular compression; it contained 1 lymphocyte per c.mm. and the Protein was 30 mg. per 100 c.cm. He was treated with massage and exercises. In the course of wo months there had been considerable improvement in the right arm; the biceps and deltoid were of normal power, the spinati and supinator longus moderately weak. The biceps jerk was feeble and die supinator jerk still absent: the sensory impairment was still 342/44