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KMID : 0371620080230020183
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Journal of Wonkwang Medical Science
2008 Volume.23 No. 2 p.183 ~ p.190
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Spinal neurofibroma having the symptom of brachial plexus lesion in patient with neurofibromatosis type Ⅰ
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Yang Chung-Yong
Park Hyo-In
Park Soon-Ah
Park Jong-Tae
Juhng Seon-Kwan
Shin Yong-Il
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Abstract
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We observed a patient with symptom similar to brachial plexus lesion caused by spinal neurofibroma in a 50-year-old female with a history of neurofibromatosis-1(NF-1). She presented with posterior neck, left shoulder and left upper arm paralysis of 4 months duration. The initial electrodiagnostic study(EDS) revealed supraclavicular preganglionic brachial plexus lesion of mainly involved left C5 and C6 roots. However, radiological imagings including axillar MRI, ultrasonography, cervical plain radiography and bone scintigraphy showed no definitive brachial plexus disease except cervical dural dilation and severe thoracic scolio-Iordosis. On 7 months after the first admission, she had aggravated muscle weakness on the left upper arm and both lower extremities, sensory impairment below C4 and respiration difficulty with the chest pain. Emergency MRI showed intradural axillar-medullary neurogenic tumor at the left C3-C4. Subsequently, the patient was treated with surgical resection. Grossly specimen examination displayed the presence of a spinal neurofibroma. In rapidly progressing spinal neurofibroma represented firstly as root lesion of brachial plexus in EDS, the physician should pay scrupulous care to evaluate the cause.
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KEYWORD
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Spinal neurofibroma, Neurofibromatosis, Preganglionic brachial plexopathy
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