Magnetic resonance neurography: Findings in a case with chronic autoimmune brachial radiculoneuritis

• Published in: Clinical neuroradiology (Munich) 2018-09, Vol.28 (S1), p.S117
• Main Authors: Knaub, Katharina, Boppel, Tobias, Schramm, Peter
• Format: Article
• Language: English
• Subjects: Cortisone; Mycophenolate mofetil
• ISSN: 1869-1439
• DOI: 10.1007/S00062-018-0719-8

Purpose: The purpose of our case report is to draw attention to chronic changes in radiculoneuritis depicted by magnetic resonance neurography (MRN). Methods: A 64-year-old man presented the first time in 1998 with a shoulder and upper arm weakness on the left side. A slight pleocytosis and autochthonous IgM-synthesis was found. Electroneurography showed hints for asymmetric polyradiculitis. He was treated with high-dose cortisone and cephalosporins. In 2014 an additional weakness in the left hand occurred. The additional proof of GM1-IgM-antibodies and a blood-brain-barrier disruption led to the diagnosis of autoimmune radiculoneuritis. Eight courses of immunglobulin therapy followed and in 2018 a treatment with mycophenolate mofetil was established. MRN was performed with 3T Philips Ingenia in a chronic stage of the disease in 2017. Results: MRN showed impressive signal alterations in the left brachial plexus with increased signal intensity and thickening in the nerve roots C4 till C7 (Fig 1 and 2) and a decreasing diameter and signal intensity in the following peripheral arm nerves. Muscle atrophy and edema in denervated muscles were seen. Conclusion: To our knowledge there is Limited data on MRN findings in autoimmune radiculoneuritis. These findings in chronic stage are suggestive that MRN may be a non-invasive examination applicable to monitor the disease.