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Enlarged Brachial Plexus Nerve Found During Ultrasound-Guided Peripheral Nerve Block Diagnosed as Charcot-Marie-Tooth Disease: A Case Report

Authors Shiraishi T, Masumoto K, Nakamura M, Hidano G

Received 1 July 2020

Accepted for publication 5 October 2020

Published 19 October 2020 Volume 2020:13 Pages 141—146


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz

Toshie Shiraishi, Kentaro Masumoto, Mitsuyo Nakamura, Gumi Hidano

Minimally Invasive Surgery Center, Department of Anesthesiology, Yotsuya Medical Cube, Tokyo, Japan

Correspondence: Toshie Shiraishi Minimally Invasive Surgery Center, Department of Anesthesiology
Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-Ku, Tokyo 102-0084, Japan
Tel +8130-3261-0401
Fax +8130-3261-0402

Abstract: Ultrasound-guided peripheral nerve block (PNB) has become a popular anesthetic procedure. We report a case of an enlarged brachial plexus nerve noted on ultrasonographic images, as part of PNB, which was diagnosed postoperatively as Charcot-Marie-Tooth disease (CMTD), an inherited neurological disorder of the peripheral nerves. Although nerve enlargement is characteristic of demyelinating diseases such as CMTD, the use of ultrasonography in the diagnosis of neurological disorders is a developing area for neurologists and anesthesiologists can lack knowledge in this emerging field. Unusual nerve presentation on ultrasonographic images during PNB anesthetic procedures should be recognized as being indicative of underlying neurologic disorders. This case highlights that increased awareness of the diagnosis of underlying neurologic disorders by ultrasonography would assist the general practice of PNB in anesthetic medicine. This is especially important as underlying neurological conditions can have important consequences for patient-appropriate anesthesia and may inform best anesthetic practice. A new category, “neurological disorder on ultrasound image”, should be introduced to PNB knowledge in anesthetic field.

Keywords: ultrasonography, local anesthesia and analgesia, neurological disorders, demyelinating diseases

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