Specialty neurology ICD-9-CM 353.5 MeSH D020968 | ICD-10 G54.5 DiseasesDB 32166 | |
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Synonyms acute brachial radiculitis, Parsonage–Aldren–Turner syndrome', neuralgic amyotrophy, brachial neuritis, brachial plexus neuropathy, brachial plexitis, acute brachial neuropathy | ||
Parsonage–Turner syndrome, also known as acute brachial neuropathy, is a syndrome of unknown cause; although many specific risk factors have been identified (such as; post-operatively, post-infectious, post-traumatic or post-vaccination), the cause is still unknown. The condition manifests as a rare set of symptoms most likely resulting from autoimmune inflammation of unknown cause of the brachial plexus. (The brachial plexus is a complex network of nerves through which impulses reach the arms, shoulders and chest.)
Contents
Parsonage–Turner syndrome occurs in about 1.6 people per 100,000 per year.
Signs and symptoms
This syndrome can begin with severe shoulder or arm pain followed by weakness and numbness. 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. MRI may assist in diagnosis.
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.
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.
Eponym
It is named after Maurice Parsonage and John Turner.
Notable cases
Mixed martial artist Todd Duffee was diagnosed with the condition in early 2013. He returned to professional fighting in December 2014.