Sir, We have read Jithendranath et al.'s case report with interest.[1] They have presented a patient with brachial plexitis after multiple bee stings. On the electromyography (EMG) report, nerve conduction studies were consistent with brachial plexus lesion located at the root level of C6, C7, C8, and T1 on the right. They have stated that brachial plexitis is possibly secondary to peripheral action on the nerve roots resulting from allergic reaction to the bee venom. However, some questions left in the minds of us, the readers. It was stated that nerve conduction studies were performed; however, what was not clarified was the day the studies were performed and whether needle EMG studies were performed. If needle EMG studies were performed were there any denervation potentials observed? There is no clear information concerning this issue. An edema on the patient's hand was mentioned. If only nerve conduction tests were performed a decrease of the conjoined muscle amplitudes can be observed secondary to the edema. This is worth keeping in mind. The brachial plexus and the roots are described separately. Brachial plexus consists of upper, middle, and lower roots. In this patient, the roots are described to be affected. It is not clear whether the roots or brachial plexus is involved. Brachial plexus magnetic resonance imaging (MRI) was normal. In cases with brachial plexitis, contrast enhancement of the brachial plexus is detected. The brachial plexus MRI can be normal if contrast is not used. For the reasons stated, some unanswered questions left in our minds. We advise the authors to bring light on this issue.
OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) defined as a syndrome characterized by recurrent upper airway obstruction episodes during sleep and excessive daytime sleepiness. OSAS is thought to be associated with increased stroke risk.