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Acute brachial plexus neuritis is an uncommon disorder that is easily confused with cervical radiculopathy.
Patients present with a characteristic pattern of acute onset of burning pain. Pain subsides in days to weeks and is then followed by profound weakness and muscle wasting changes affecting the shoulder and upper extremity. Weakness is best identified in the deltoid, biceps and rotator cuff muscles. Strength gradually recovers over 3-4 months.
DDX: The constellation of pain, weakness and sensory loss associated with cervical radiculopathy tend to occur simultaneously. Also cervical radiculopathy tends to involve only a single root.
ED treatment is with analgesics and physical therapy and PCP referral for outpatient MRI/EMG. Consider a sling in those with severe shoulder weakness.