Neuralgic amyotrophy associated with Bartonella henselae infection

We report three patients with a brachial plexus neuropathy diagnosed as neuralgic amyotrophy (NA) preceded by a proven Bartonella henselae infection. Neuralgic amyotrophy is a disabling disease involving the brachial plexus, with attacks of severe shoulder and arm pain followed by weakness and sensory involvement. Several observations support the hypothesis of an immune-mediated genesis. First, brachial plexus biopsies of NA patients in the (sub)acute stage show inflammatory changes.3 Second, antiganglioside antibodies are reported to be associated with NA. Third, several immune-triggering events, most frequently infections (50%), are known to precede NA. Various micro-organisms preceding NA have been reported (see table 1) but not yet B henselae. [...]