Well-recognised uncommon condition with exact cause not known
Synonyms:
Brachial plexus neuritis, Patchwork amyotrophy, Localised neuritis of the shoulder girdle, Seratus magnus paralysis, Multiple neuritis of the shoulder girdle, Acute brachial radiculitis, Shoulder-girdle syndrome, Paralytic brachial neuritis, Acute shoulder neuritis, Acute scapula-humeral palsy, Brachial plexus neuropathy!!
Clinical features:
Sudden onset of pain across the top of the shoulder blade, lasts from a few hours to fortnight; followed by marked shoulder girdle muscle weakness and wasting and often arm. All patients may not recall pain. Wekness appears, pain stops. Sensation is preserved. May cause secondary shoulder impingement.
Investigations:
Nerve conduction studies - EMG.
Suprascapular nerve is almost invariably involved (97% ) , followed by axillary nerve (50%) and subscapular nerve is involved in only 3%.
Imaging:
Edema in the muscles of the shoulder girdle.
Fatty atrophy of the muscles
Treatment:
No specific treatment
Pain releif
Phisiotherapy and rehabilitation
Prognosis:
Generally good, about 75% recover completely in 2 years. Period of recovery varies from 6 months to 5 years.
References:
1. M. J. Parsonage, J. W. Aldren Turner:Neuralgic amyotrophy. The shoulder-girdle syndrome. The Lancet, London, 1948, I: 973-978.
2. Ryan M et al. Whole body magnetic resonance imaging in the diagnosis of Parsonage Turner syndrome. Acta Radiol. 2004 Aug;45(5):534-9. (PMID: 15515516)
3. Gaskin CM et al. Parsonage-Turner Syndrome: MR Imaging Findings and Clinical Information of 27 Patients. Radiology 2006 240: 501-507
Journal Watch:
1. Richard E et al. MRI Findings of 26 Patients with Parsonage-Turner Syndrome. AJR 2007;189:39-44
