Brachial neuritis with phrenic nerve involvement

We report a 73-year-old woman with a complicated occurrence of brachial neuritis (BN) with phrenic nerve involvement. Our patient developed shortness of breath (ShOB) post coronary artery bypass graft secondary to phrenic nerve palsy and in the following year developed right arm pain and weakness. Electromyography confirmed the diagnosis of BN. Despite the passage of time, the ShOB worsened. This was initially attributed to the ongoing post-operative phrenic nerve palsy but on further investigation it was found to be related to the BN process. BN is an uncommon entity and when associated with distant nerve involvement, diagnostic confusion can ensue. Further difficulties arise when the patient has underlying co-morbidities that also affect nerve function such as diabetes. This article aims to explore these issues and examine the literature for prognosis and management considerations. (C) 2012 Elsevier Ltd. All rights reserved.