Parsonage–Turner syndrome: Difference between revisions
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'''Parsonage–Turner syndrome''' is also known as '''acute brachial [[neuropathy]]''' and '''acute brachial [[radiculitis]]'''.<ref name="wheelessonline">{{cite web|author=Wheeless, Clifford R.|title=Parsonage-Turner Syndrome| url= http://www.wheelessonline.com/ortho/parsonage_turner_syndrome | publisher=Wheeless' Textbook of Orthopedics @ wheelessonline.com |date=30 |
'''Parsonage–Turner syndrome''' is also known as '''acute brachial [[neuropathy]]''' and '''acute brachial [[radiculitis]]'''.<ref name="wheelessonline">{{cite web|author=Wheeless, Clifford R.|title=Parsonage-Turner Syndrome| url= http://www.wheelessonline.com/ortho/parsonage_turner_syndrome | publisher=Wheeless' Textbook of Orthopedics @ wheelessonline.com |date=30 August 2009|accessdate=2009-10-11}}</ref> Other names used are '''Parsonage–Aldren–Turner syndrome''', '''[[neuralgia|neuralgic]] [[amyotrophy]]''',<ref name="AlberstoneSteinmetz2009">{{cite book|author1=Cary D. Alberstone|author2=Michael Steinmetz|author3=Edward C. Benzel|title=Anatomic Basis of Neurologic Diagnosis|url=https://books.google.com/books?id=7VG1om3OmyUC&pg=PA105|accessdate=4 November 2010|date=28 January 2009|publisher=Thieme|isbn=978-0-86577-976-1|pages=105–}}</ref> '''brachial [[neuritis]]''', '''brachial plexus neuropathy''',<ref name="Rockwood2009">{{cite book|author=Charles A. Rockwood|title=The Shoulder|url=https://books.google.com/books?id=7ca8iqAPo2UC&pg=PA1376|accessdate=4 November 2010|date=14 January 2009|publisher=Elsevier Health Sciences|isbn=978-1-4160-3427-8|pages=1376–}}</ref> or '''brachial plexitis'''. |
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The syndrome is idiopathic; although many specific risk factors have been identified (such as; post-operatively, post-infectious, post-traumatic or post-vaccination) |
The syndrome is idiopathic; although many specific risk factors have been identified (such as; post-operatively, post-infectious, post-traumatic or post-vaccination),<ref name="pmid21886536">{{cite journal |vauthors=Feinberg JH, Radecki J |title=Parsonage-turner syndrome |journal=HSS J |volume=6 |issue=2 |pages=199–205 |year=2010 |pmid=21886536 |pmc=2926354 |doi=10.1007/s11420-010-9176-x |url=}}</ref> 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]].<ref name="ninds">{{cite web | url= http://www.ninds.nih.gov/disorders/brachial_plexus/brachial_plexus.htm | title=NINDS Brachial Plexus Injuries: Information Page | publisher=National Institute of Neurological Disorders and Stroke | date=September 29, 2008 |accessdate=2009-10-11}}</ref> (The brachial plexus is a complex network of nerves through which impulses reach the arms, shoulders and chest.) |
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Parsonage–Turner syndrome has an incidence of 1.64 cases in 100,000 people |
Parsonage–Turner syndrome has an incidence of 1.64 cases in 100,000 people.<ref name="pmid2996415">{{cite journal |vauthors=Beghi E, Kurland LT, Mulder DW, Nicolosi A |title=Brachial plexus neuropathy in the population of Rochester, Minnesota, 1970-1981 |journal=Ann. Neurol. |volume=18 |issue=3 |pages=320–3 |year=1985 |pmid=2996415 |doi=10.1002/ana.410180308 }}</ref> |
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==Mechanism== |
==Mechanism== |
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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 muscle|deltoid]] is more variable, as it is innervated by the [[axillary nerve]].<ref name="rad">{{cite web|url=http://radiopaedia.org/articles/parsonage-turner-syndrome-1|author=Frank Gaillard MD|publisher=Radiopaedia}}</ref> |
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 muscle|deltoid]] is more variable, as it is innervated by the [[axillary nerve]].<ref name="rad">{{cite web|url=http://radiopaedia.org/articles/parsonage-turner-syndrome-1|title=Parsonage-Turner syndrome|author=Frank Gaillard MD|publisher=Radiopaedia}}</ref> |
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==Signs and symptoms== |
==Signs and symptoms== |
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==References== |
==References== |
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==External links== |
==External links== |
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Revision as of 15:11, 29 December 2016
| Parsonage–Turner syndrome | |
|---|---|
| Specialty | Neurology  |
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),[4] 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.[5] (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.[6]
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.[7]
Signs and symptoms
This syndrome can begin with severe shoulder or arm pain followed by weakness and numbness.[5] 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.[citation needed] MRI may assist in diagnosis.[8]
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.[citation needed]
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.[7]
Eponym
It is named after Maurice Parsonage and John Turner.[9][10]
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
- ^ Wheeless, Clifford R. (30 August 2009). "Parsonage-Turner Syndrome". Wheeless' Textbook of Orthopedics @ wheelessonline.com. Retrieved 2009-10-11.
- ^ 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.
- ^ Charles A. Rockwood (14 January 2009). The Shoulder. Elsevier Health Sciences. pp. 1376–. ISBN 978-1-4160-3427-8. Retrieved 4 November 2010.
- ^ Feinberg JH, Radecki J (2010). "Parsonage-turner syndrome". HSS J. 6 (2): 199–205. doi:10.1007/s11420-010-9176-x. PMC 2926354. PMID 21886536.
- ^ a b "NINDS Brachial Plexus Injuries: Information Page". National Institute of Neurological Disorders and Stroke. September 29, 2008. Retrieved 2009-10-11.
- ^ Beghi E, Kurland LT, Mulder DW, Nicolosi A (1985). "Brachial plexus neuropathy in the population of Rochester, Minnesota, 1970-1981". Ann. Neurol. 18 (3): 320–3. doi:10.1002/ana.410180308. PMID 2996415.
- ^ a b Frank Gaillard MD. "Parsonage-Turner syndrome". Radiopaedia.
- ^ 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.
- ^ synd/1910 at Who Named It?
- ^ 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.