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.

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    3 were partial from the beginning, and of these one had shown definite improvement after three months, while the other two were apparently stationary in the same period. Of the complete cases, 1 recovered completely in four months, while 5 had shown partial recovery in periods ranging from three to seven months ; the remaining cases still had complete palsies when last examined at periods ranging from three to eighteen months after the onset. Once marked atrophy has occurred in a muscle the prospect of recovery is poor ; when localized atrophy is only slight, considerable and even complete recovery may occur, though * the onset of recovery may be delayed for as long as six months and possibly more. In a few cases recovery has started within three to four weeks and has'progressed‘rapidly. Pathogenesis There has as yet been no pathological material available from cases of this disorder ; it appears, on clinical grounds, that the condition can affect single peripheral nerves, nerve roots, or combinations of these. Riddoch (1944) has suggested that the anterior horn cells may be involved in some cases, basing this view on the rapid muscular wasting which may be present and on the scattered nature of the muscular involve¬ ment which is occasionally seen. • No exactly comparable condition seems to occur in the lower limbs. The best name for the disorder is uncertain in the absence of a known aetiology or pathology. Acute brachial neuritis is already used for a different clinical syndrome, and the name applied by Spillane of “ localized neuritis around the shoulder girdle ” is hardly comprehensive enough. For these reasons the te^m “ acute brachial radiculitis ” has been applied to it for the time being till more is known about its aetiology. The differential points from anterior poliomyelitis, to which it bears some clinical resemblance, have been admirably summarized by Spillane, the main ones being: the absence of signs of general disturbance in the acute stage ; the normal C.S.F. when this has been examined early in the illness ; the sensory impairment in a number of the cases ; .and the occurrence of these cases in the absence of typical cases of poliomyelitis in the same district at the same time. To these may be added the fact that it may occur at the age of 50— a most unusual happening with poliomyelitis. The aetiology of the condition is still speculative, and the somewhat mixed group of apparently precipitating causes has not helped on this point. It has been suggested that a virus infection is the cause: the main point against this is the absence of fever or other signs of general infection and the normal C.S.F. findings. In most diseases due to neurotropic viruses—even in zoster, in which the main incidence of the infection is on the posterior root ganglia—an increase of cells is found in the C.S.F. There is one condition which has a very close clinical resemblance to it, and that is serum neuritis (Kennedy, 1929 ; Young, 1932). This may occur after the injection of any form