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Norplant neuropathy: peripheral neurologic symptoms associated with subdermal contraceptive implants.

1995; National Institutes of Health; Volume: 40; Issue: 2 Linguagem: Inglês

William J. Hueston, K T Locke,

Botulinum Toxin and Related Neurological Disorders

Seventy to 80% of women using subdermal contraceptive implants (Norplant) have reported side effects, such as uterine bleeding, headache, mastalgia, and local pain at the site of insertion. This is a report of two patients who presented with peripheral neuropathy associated with the implants. One patient responded to removal of the device. The second patient, whose symptoms were thought to be related to trauma, was successfully treated with nonsteroidal anti-inflammatory agents.Two cases of peripheral neuropathy associated with subdermal contraceptive implants (Norplant) are reported. In the first case, a 22-year-old woman had received an implant in her left arm 11 months earlier. This woman was small and slender, and her implant rested nearly in the axilla. Whenever she rotated her arms internally, she experienced an electric shock-type pain shooting down the anterolateral aspect of her left arm to her fingers and causing parenthesia and numbness. The sensation lasted 2-3 minutes. This pain could be reproduced by pressing the superior portion of the axillary subdermal capsules. Following removal, her arm returned to normal. In the second case, a 26-year-old woman who had an implant for a year experienced a trauma to her left arm 3 days before she sought treatment. She stated that she experienced acute immediate pain in her upper arm after it was grabbed. The next day she experienced parenthesia and numbness radiating down the lateral aspect of her arm to her hand. Symptoms could be reproduced by palpitating the proximal tip of the capsule situated closest to the biceps muscle. The patient did not want to have the implant removed, so she was treated with a nonsteroidal anti-inflammatory agent for 2 weeks, and her symptoms disappeared. The pain experienced in these cases may represent compression of the musculocutaneous nerve by the capsule, resulting in a "Norplant neuropathy." If this condition becomes more common, providers might consider orienting the subdermal capsules in the direction of the elbow rather than the axilla, especially in women with short upper arms.