Parsonage Turner Syndrome

Parsonage Turner Syndrome

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Parsonage Turner Syndrome is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Brachial Neuritis
  • Brachial Plexus Neuritis
  • Idiopathic Brachial Plexus Neuropathy
  • Neuralgic Amyotrophy

Disorder Subdivisions

  • None

General Discussion

Parsonage-Turner syndrome is a relatively common condition characterized by inflammation of the network of nerves that control and supply (innervate) the muscles of the chest, shoulders, and arms (brachial plexus). Individuals with the condition first experience a sudden onset of severe pain across the shoulder and upper arm. The muscles of the affected shoulder show weakness, wasting (atrophy), and paralysis (atrophic paralysis) within a few hours or days of the onset of the disorder. Although individuals with the condition may experience paralysis of the affected areas that lasts for months or years in some cases, recovery is usually complete. The exact cause of Parsonage-Turner syndrome is not known.

Symptoms

Parsonage-Turner syndrome is a neuromuscular condition. It is characterized by the sudden (acute) onset of severe pain across the shoulder and upper arm due to inflammation of the group of nerves that control the muscles of the chest, shoulders, and arms (brachial plexus). In some cases, the pain may radiate down the arm and into the hand. The degree and intensity of the pain varies among those affected, so that some patients feel no pain but exhibit weakness of the muscles. Local pain around the shoulder girdle is the characteristic symptom. The pain may extend toward the elbow, but seldom beyond the elbow.



Within a few hours or days of the condition's onset, affected individuals may experience muscle weakness, wasting (atrophy), numbness (hyperesthesia), and paralysis of the muscles of the affected shoulder and, in rare cases, muscles of the hand and fingers. In some cases, the condition may affect both sides of the body (bilateral). People with this condition usually recover within a few months although symptoms may sometimes last for a few years. Recovery is usually complete.

Causes

The exact cause of Parsonage-Turner syndrome is not known. This disorder has been associated with bacterial or viral infections, particularly of the upper respiratory tract. Also implicated have been parasitic infections, surgery, vaccinations, childbirth, and various intrusive medical procedures such as lumbar puncture and X-ray opaque dyes. Some clinical-scientists believe that this may be an autoimmune disorder. Autoimmune disorders are caused when the body's natural defenses against "foreign" or invading organisms (e.g., antibodies) begin to attack healthy tissue for unknown reasons.



Parsonage-Turner syndrome may also arise as a result of another systemic illness, such as polyarteritis nodosa, lymphoma, systemic lupus erythematosis, temporal arthritis, and Ehlers-Danlos syndrome.

Affected Populations

Parsonage-Turner syndrome can affect anyone, but is seen most often in young to middle aged adult males.

Standard Therapies

Diagnosis

The diagnosis of Parsonage-Turner syndrome is made by exclusion. Many other syndromes mimic PTS. X-rays and MRI studies (magnetic resonance imaging studies) may be used in the process of exclusion.



Treatment

There is no treatment specifically effective for PTS. Many patients will recover without any treatment. Physical therapy or surgery may be helpful for some people with this disorder. Other treatment is symptomatic and supportive.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.



For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com

References

TEXTBOOKS

Sahoo S, Pearl PL. Parsonage-Turner Syndrome. In: NORD Guide to Rare Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2003:577-78.



Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:1490-92.



Berkow R., ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:581-82.



JOURNAL ARTCILES

Elsayes KM, Sharriff A, Staveteig PT, et al. Value of magnetic resonance imaging for muscle denervation syndromes of the shoulder girdle. J Comput Assist Tomogr. 2005;29:326-29.



Ryan M, Twair A, Nelson E, et al. Whole body magnetic resonance imaging in the diagnosis of Parsonage Turner syndrome. Acta Radiol. 2004;45:534-39.



Khandelwal D, Bhatia M, Singh S, et al. Threshold intensity and central motor conduction time in patients with monomelic amyotrophy: a transcranial magnetic stimulation evaluation. Electromyogr Clin Neurophysiol. 2004;44:357-60.



McGillicuddy JE. Cervical radiculopathy, entrapment neuropathy, and thoracic outlet syndrome: how to differentiate? Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg Spine. 2004;1:179-87.



Akuhota V, Chou LH, Drake DF, et al. Sports and performing arts medicine. 2. Shoulder and elbow overuse injuries in sports. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):S52-S58.



Coppieters MW, Stappaerts KH, Wouters LL, et al. The immediate effects of cervical lateral glide treatment technique in patients with neurogenic cervicobrachial pain. J Orthop Sports Phys Ther. 2003;33:369-78.



Kufeld M, Claus B, Campi A, et al. Three-dimensional rotational myelography. AJNR Am J Neuroradiol. 2003;24:1290-93.



FROM THE INTERNET

Ashworth NL. Brachial Neuritis. emedicine. Last Updated: May 16, 2005. 11pp.

www.emedicine.com/pmr/topic58.htm



Kolev I. Parsonage-Turner syndrome. Orphanet. Update: July 2004. 7pp.

www.orpha.net/data/patho/GB/uk-Turner.pdf



Nerve: Proximal Motor. Neuralgic amyotrophy. Neuromuscular Center. Washington University of St. Louis. nd. 3pp.

www.neuro.wustl.edu/neuromuscular/nanatomy/proxmot.html#heredbp

Resources

American Autoimmune Related Diseases Association, Inc.

22100 Gratiot Ave.

Eastpointe, MI 48021

Tel: (586)776-3900

Fax: (586)776-3903

Tel: (800)598-4668

Email: aarda@aarda.org

Internet: http://www.aarda.org/



NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

Information Clearinghouse

One AMS Circle

Bethesda, MD 20892-3675

USA

Tel: (301)495-4484

Fax: (301)718-6366

Tel: (877)226-4267

TDD: (301)565-2966

Email: NIAMSinfo@mail.nih.gov

Internet: http://www.niams.nih.gov/



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



AutoImmunity Community

Email: moderator@autoimmunitycommunity.org

Internet: http://www.autoimmunitycommunity.org



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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