Parsonage–Turner syndrome

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Parsonage–Turner syndrome (PTS), also known as acute brachial neuritis or brachial plexopathy, is a rare neurological disorder characterized by sudden onset of severe shoulder and upper arm pain followed by muscle weakness and atrophy. The condition primarily affects the brachial plexus, a network of nerves that sends signals from the spinal cord to the shoulder, arm, and hand.

Signs and Symptoms

The hallmark of Parsonage–Turner syndrome is the sudden onset of severe pain in the shoulder and upper arm, which can last from hours to weeks. This pain is typically followed by muscle weakness, atrophy, and sometimes sensory loss in the affected areas. The symptoms often appear on one side of the body but can occasionally affect both sides.

Causes

The exact cause of Parsonage–Turner syndrome is unknown. However, it is believed to be related to an autoimmune response, where the body's immune system mistakenly attacks the nerves of the brachial plexus. Possible triggers include infections, vaccinations, surgery, or trauma.

Diagnosis

Diagnosis of Parsonage–Turner syndrome is primarily clinical, based on the patient's history and physical examination. Electromyography (EMG) and nerve conduction studies (NCS) can help confirm the diagnosis by showing characteristic patterns of nerve damage. Magnetic resonance imaging (MRI) may also be used to rule out other conditions.

Treatment

There is no specific cure for Parsonage–Turner syndrome. Treatment focuses on managing pain and improving function. Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and physical therapy are commonly used. In some cases, nerve blocks or opioids may be necessary for pain management.

Prognosis

The prognosis for Parsonage–Turner syndrome varies. While many patients experience significant recovery within 1 to 2 years, some may have persistent weakness or pain. Early intervention with physical therapy can improve outcomes.

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