Parsonage–Turner syndrome

Parsonage–Turner syndrome

The right brachial plexus with its short branches, viewed from in front.
Classification and external resources
Specialty neurology
ICD-10 G54.5
ICD-9-CM 353.5
DiseasesDB 32166
MeSH D020968

Parsonage–Turner syndrome is also known as acute brachial neuropathy and acute brachial radiculitis.[1] Other names used are Parsonage–Aldren–Turner syndrome, neuralgic amyotrophy,[2] brachial neuritis, brachial plexus neuropathy,[3] or brachial plexitis.

The syndrome is idiopathic; although many specific risk factors have been identified (such as; post-operatively, post-infectious, post-traumatic or post-vaccination) the aetiology is still unknown. The condition manifests as a rare set of symptoms most likely resulting from autoimmune inflammation of unknown etiology of the brachial plexus.[4] (The brachial plexus is a complex network of nerves through which impulses reach the arms, shoulders and chest.)

Parsonage-Turner syndrome has an incidence of 1.64 cases in 100,000 people

Mechanism

Parsonage-Turner involves neuropathy of the suprascapular nerve in 97% of cases, and variably involves the axillary and subscapular nerves. As such, the muscles usually involved are the supraspinatus and infraspinatus, which are both innervated by the suprascapular nerve. Involvement of the deltoid is more variable, as it is innervated by the axillary nerve.[5]

Signs and symptoms

This syndrome can begin with severe shoulder or arm pain followed by weakness and numbness.[4] Those who suffer from Parsonage–Turner experience acute, sudden-onset pain radiating from the shoulder to the upper arm. Affected muscles become weak and atrophied, and in advanced cases, paralyzed. Occasionally, there will be no pain and just paralysis, and sometimes just pain, not ending in paralysis. It is reported that similar to cerebral palsy, the disease can affect brain function. Some neurologists think that this is the most painful condition in neurology. MRI may assist in diagnosis.[6]

Prognosis

Despite its wasting and at times long-lasting effects, most cases resolve themselves and recovery is usually good in 18–24 months, depending on how old the person in question is. For instance, a six-year-old could have brachial neuritis for only around 6 months, but a person in their early fifties could have it for over 3 years.

Differential diagnosis

The differential focuses on distinguishing it from similar entities such as quadrilateral space syndrome, which involves the teres minor and variably the deltoid, and suprascapular nerve impingement at the spinoglenoid notch, which predominantly involves the infraspinatus.[5]

Eponym

It is named after Maurice Parsonage and John Turner.[7][8]

Notable cases

Mixed martial artist Todd Duffee was diagnosed with the condition in early 2013. He returned to professional fighting in December 2014.

See also

References

  1. ↑ Wheeless, Clifford R. (30 Updated August 2009). "Parsonage-Turner Syndrome". Wheeless' Textbook of Orthopedics @ wheelessonline.com. Retrieved 2009-10-11. Check date values in: |date= (help)
  2. ↑ Cary D. Alberstone; Michael Steinmetz; Edward C. Benzel (28 January 2009). Anatomic Basis of Neurologic Diagnosis. Thieme. pp. 105–. ISBN 978-0-86577-976-1. Retrieved 4 November 2010.
  3. ↑ Charles A. Rockwood (14 January 2009). The Shoulder. Elsevier Health Sciences. pp. 1376–. ISBN 978-1-4160-3427-8. Retrieved 4 November 2010.
  4. 1 2 "NINDS Brachial Plexus Injuries: Information Page". National Institute of Neurological Disorders and Stroke. Last updated September 29, 2008 - see bottom of webpage). Retrieved 2009-10-11. Check date values in: |date= (help)
  5. 1 2 Frank Gaillard MD. Radiopaedia http://radiopaedia.org/articles/parsonage-turner-syndrome-1. Missing or empty |title= (help)
  6. ↑ William E. Brant; Clyde A. Helms (2007). Fundamentals of diagnostic radiology. Lippincott Williams & Wilkins. pp. 1–. ISBN 978-0-7817-6135-2. Retrieved 4 November 2010.
  7. ↑ synd/1910 at Who Named It?
  8. ↑ Parsonage MJ, Turner JW (June 1948). "Neuralgic amyotrophy; the shoulder-girdle syndrome". Lancet 1 (6513): 973–8. doi:10.1016/S0140-6736(48)90611-4. PMID 18866299.

External links

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