Severe bilateral amyotrophic neuralgia associated with major dysphagia secondary to acute hepatitis E [v2; ref status: indexed, http://f1000r.es/2q8]

Several acute neurological syndromes can be triggered by Introduction: immune events. Hepatitis E virus (HEV), an emerging infectious disease, can be one of these triggers. We report the case of a 36-year-old man that presented nausea Case report: and a dull abdominal pain for a week and then felt an acute neuralgic pain involving both shoulders that lasted for 8 to 10 hours. Immediately after, the patient presented a severe bilateral muscular weakness of the proximal part of both upper limbs, corresponding to an amyotrophic neuralgia. Two days after the shoulder pain, the patient presented a dysphagia necessitating tube feeding. A blood sample confirmed hepatitis caused by hepatitis E virus (HEV; genotype 3F). Oral feeding resumed progressively after five months. The patient was fully independent for the activities of daily living but was still unable to work after six months. Amyotrophic neuralgia and hepatitis E are both under-diagnosed. Conclusion: It is noteworthy that HEV can trigger amyotrophic neuralgia. Antiviral drugs, oral steroids and intravenous immunoglobulins can be proposed, but the optimal treatment has not yet been determined. Referees v1 published 26 Nov 2013 v2 published 06 Jan 2014 1 2 3 4 report report report report 26 Nov 2013, :259 (doi: 10.12688/f1000research.2-259.v1) First Published: 2 06 Jan 2014, :259 (doi: 10.12688/f1000research.2-259.v2) Latest Published: 2 v2 Page 1 of 7 F1000Research 2014, 2:259 Last updated: 08 JAN 2014