Neuralgische amyotrofie in de eerste lijn*

Objective

To assess the incidence of classic neuralgic amyotrophy (NA) in a primary care setting.

Design

Prospective cohort study.

Method

During the year 2012 we registered all new cases of neck, shoulder or arm symptoms from two large primary care centres serving a population of 14,118. Prior to commencing the study, general practitioners attended a short training session on how to diagnose classic NA. After inclusion, patients in whom general practitioners suspected NA were offered a neurologic assessment for diagnostic confirmation.

Results

Of the 492 patients identified with new onset of neck, shoulder or arm symptoms, 34 were suspected of having NA. Neurologic evaluation confirmed the diagnosis in 14 patients. For the Netherlands, this translates to an incidence of 1 in 1,000.

Conclusion

Our findings suggest that NA is 30-50 times more common than previously thought; in the Netherlands, this would mean 17,000 instead of 500 new cases each year. Lack of awareness of the disorder and its clinical presentation seems the most likely explanation for this difference. Since NA may lead to sustained symptoms and functional limitations in the chronic phase, increased attention is urgently required to improve diagnostics and treatment.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.