Parsonage-Turner Syndrome: Understanding Nerve Damage Introduction Shoulder pain is a common complaint in both the primary and sports medicine setting.
Parsonage-Turner Syndrome: Understanding Nerve Damage Shoulder pain is a common complaint in both the primary and sports medicine setting. There are occasions that odd presentations walk into the clinic that make providers expand their differential diagnosis and think outside the box. Parsonage-Turner syndrome (PTS) tends to be one of these diagnoses and can present in a multitude of ways.
There are case reports with possible antecedent events such as medication reaction, parasite infection, dysphonia, burns, calcific tendonitis, hepatitis, infection, among others. The incidence was found to be 1.64 per 100,000 in a Minnesota population and predominated between the third and seventh decades of life, with men being more commonly affected. The incidence was found to be 1.64 cases per 100,000 inhabitants, in the population of Minnesota, United States, with occurrences predominantly between the third and seventh decades of life.17,18 Men are more affected than women, with a ratio of between 2:1 and 11.5:1.11 The prognosis is good in most cases, given that PTS is self-limiting and has a low recurrence rate.11 The treatment is generally successful, with use of analgesics and physiotherapy in order to maintain the range of motion and strengthen muscles Parsonage-Turner syndrome is also known as neuralgic amyotrophy, paralytic brachial neuritis, idiopathic brachial plexopathy or acute brachial radiculitis.
It is described in both children and adults and consists of a sudden, rather abrupt, unilateral shoulder or upper extremity pain that may begin rather insidiously but quickly amplifies in severity and intensity. It was first reported in 1948 by the Parsonage and Turner, but similar clinical presentations were described as far back as 1897. Labeled diagram of the brachial plexus It is considered to be an inflammatory condition of the brachial plexus, but the pathophysiology is somewhat unknown.
Electrophysiologic studies suggest it is a multifocal process rather than a global process and involves motor serves more frequently when compared to sensory nerves. The exact pathophysiology is complex and incompletely understood. Mechanical processes such as positions related to surgical procedures, autoimmune, genetic and infectious processes have been proposed.
An antecedent event has been identified in around 50 percent of cases and immune mediated response has been shown in 20-40 percent of cases. It has also been associated with coronary artery bypass, oral surgery, hysterectomy and a variety of orthopedic procedures. Van Alfen suggests that the pathophysiology of the condition involves an interaction between a genetic predisposition, mechanical vulnerability, and an autoimmune trigger.
If you are experiencing symptoms that may be related to parsonage turner syndrome, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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