Rash Decisions in Neurology: A Case Report of Brachioradial Pruritus Secondary to Cervical Intramedullary Lesion

Gupta, Dhananjay; Shetty, Nikith; Shivaprasad, Akhil; Javali, Mahendra; Pradeep, R; Mehta, Anish; Acharya, Purushottam; Srinivasa, Rangasetty

doi:10.4103/0028-3886.325376

Neurol India

2021

DOI: 10.4103/0028-3886.325376

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Rash Decisions in Neurology: A Case Report of Brachioradial Pruritus Secondary to Cervical Intramedullary Lesion

Dhananjay Gupta

Nikith Shetty

Akhil Shivaprasad

et al.

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2022

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Brachioradial Pruritus: Clinical, Electromyographic, and Cervical MRI Features in Nine Patients

Shields¹,

Iyer²,

Shields³

2022

Cureus

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BackgroundBrachioradial pruritus (BRP) is a neuropathic dysesthesia manifesting as pruritus over the dorsolateral forearm. While the etiology is unknown, intensive sun exposure and cervical spine disease have been proposed. This study describes the clinical, electrodiagnostic (EDX), and cervical MRI findings in nine patients diagnosed with BRP. Materials and methodsAll patients underwent EDX and cervical MRIs. Numerous metrics were documented including presenting symptoms, neurological examination, EDX findings, and cervical MRI features. ResultsAll nine patients experienced pruritus of the arms/forearms, typical of BRP, which was unilateral in eight (89%) cases. Decreased pinprick sensation was noted in the arms/forearms (five [56%] patients) or of the thumbs, index, and/or middle fingers (four [44%] patients). Four (44%) patients had either decreased or absent biceps and brachioradialis deep tendon reflexes (DTRs), while one (11%) patient had decreased triceps and brachioradialis DTRs. The EDX revealed abnormalities in eight (89%) patients. Increased polyphasic units, decreased motor units, and/or denervation changes were recorded by needle electromyography (EMG) in eight (89%) patients: the biceps in seven (88%) and both the brachioradialis and triceps in four (50%) patients. The EMG abnormalities indicated chronic radiculopathy involving C6 in six patients and C5 and C6 in one patient. All nine patients had cervical spine disease, encompassing disc protrusions, spondylosis, spinal stenosis, and/or foraminal stenosis. ConclusionsBRP in this series of patients was accompanied by chronic cervical radiculopathy involving predominantly C6 and C5. EDX and cervical spine MR imaging should be considered essential investigations in the evaluation of patients with BRP.

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Brachioradial Pruritus: Clinical, Electromyographic, and Cervical MRI Features in Nine Patients

Shields¹,

Iyer²,

Shields³

2022

Cureus

View full text Add to dashboard Cite

show abstract

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Rash Decisions in Neurology: A Case Report of Brachioradial Pruritus Secondary to Cervical Intramedullary Lesion

Cited by 1 publication

References 9 publications

Brachioradial Pruritus: Clinical, Electromyographic, and Cervical MRI Features in Nine Patients

Brachioradial Pruritus: Clinical, Electromyographic, and Cervical MRI Features in Nine Patients

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