| 제목 |
Brachial Plexus injury by Miradry, a microwave-based treatment for axillary hyperhidrosis |
| 소속 |
Incheon St. Mary`s hospital, The Catholic University of Korea, Department of Rehabilitation Medicine1 |
| 저자 |
Young Min Kim1*, Mi Jung Yoon 1, Min Wook Kim1† |
INTRODUCTION
Miradry, a microwave -thermolysis device, is comparably a new non-surgical agent in the field of eradication of sweat glands, which is expected to relieve discomfort of patients suffering from axillary hyperhidrosis and omidrosis. However, adverse events related to procedure of microwave thermolysis device have not yet been fully studied. In this paper, we would like to report a case of 30 year old women, who has suffered from brachial plexus injury after undergoing Miradry microwave thermolysis.
CASE REPORT
A thirty-year-old, right hand dominant female had undergone Miradry procedure at local dermatology clinic to treat axillary hyperhidrosis. During the procedure, she noticed a sharp pain with burning sensation on bilateral axillar, and the next day she felt weakness and numbness on her left first to third fingers. On the 7th day of April 2020, approximately 3 months after Miradry, the patient had decided to undergo electromyography in outpatient clinic of our institution. The electromyography result was as follows:
This evaluation demonstrated that her symptom is electrodiagnostically compatible with ‘Left brachial plexopathy mainly involving musculocutaneous nerve and median nerve, branch level, with partial axonotemesis’
Also, on the ultrasound evaluation of the affected side, increased sizes and hypoechogenicity with less distinctive neuronal fascicle of musculocutaneous nerve and median nerve of left arm was observed, which supports the electrodiagnostic result. (Fig4, Fig5)
CONCLUSION
One month after EMG and ultrasound evaluation, the patient appealed that there was no improvement of weakness and tingling sensation, over the phone. As microwave thermolysis is becoming more in use as a substitution for surgical removal of sweat glands as to treat axillary hyperhidrosis and omidrosis permanently, more study should be performed to discover its serious adverse effects, along with characteristics of candidates who would be venerable.
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Fig 4 : Median nerve US images, obtained from axillary, elbow, and mid forearm over both arms. At axillar, Median nerve cross sectional area (CSA) reaches up to 0.202cm2 on the affected left side, while 0.091cm2 was measured from right side. At the elbow, CSA of median nerve was 0.167 cm2 and 0.088 cm2 from left, and right side respectively. At mid forearm, CSA was 0.095 cm2 and 0.041 cm2 from left, and right side respectively.
Fig 5: At the left mid-arm, the musculocuteaneous nerve (white arrowhead) lies among the proximal part of biceps brachii muscle. Less distinctive neuronal fascicle of musculocutaneous nerve was observed.
NCS and EMG
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