Diagnostic Accuracy of Clinical Characteristics to Diagnose Neuralgic Amyotrophy
Khanittanuphong P, MD¹, Boonmeeprakob A, BNS¹
Affiliation : ¹ Division of Rehabilitation, Department of Orthopedics and Rehabilitation Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective: To evaluate the diagnostic accuracy of clinical symptoms in neuralgic amyotrophy (NA).
Materials and Methods: The present study was a retrospective 10-year review of patients suspected of NA and referred to an electrodiagnostic clinic for confirmation. Symptoms including first presenting symptom, duration, natural history of disease, pain area, and characteristics were collected, and sensitivity, specificity, positive and negative likelihood ratios were analyzed using the electrodiagnostic findings (EDX) as the gold standard.
Results: Ninety-six patients were included, and 52 patients were confirmed to have NA by the EDX. The first presentation of pain showed a sensitivity of 84.6% and the lowest negative likelihood ratio of 0.38. Hand pain, finger pain, pins and needles pain, and electrical shock-like pain had the highest specificity of 95.5%, but low positive likelihood ratios (PLRs) of 0.85, 1.27, 0.42, and 1.27, respectively. However, pain followed by abrupt weakness revealed a specificity of 88.6% with the highest PLR of 3.55.
Conclusion: The highest sensitivity and a good specificity to diagnose NA were the first presentation of pain and clinical course of pain followed by abrupt weakness, respectively.
Received 23 Sep 2019 | Revised 9 Jan 2020 | Accepted 16 Jan 2020
Keywords : Diagnostic accuracy, Clinical characteristics, Neuralgic amyotrophy
