Parsonage turner Syndrome – Symptoms, Causes, Treatment and MRI

Do you often suffer from acute shoulder pain? Is it accompanied by muscle weakness and upper arm pain? If you possess these problems, you may be suffering from a disease called Parsonage turner Syndrome. Read to know all about this disease and its symptoms, causes and treatment.

What is Parsonage turner Syndrome?

Parsonage Turner syndrome, characterized by sudden onset of excruciating unilateral shoulder and upper arm pain, is a rare syndrome bearing upon the lower motor neurons of the brachial plexus. The brachial plexus is a network of nerve bundles, through which impulses from the spinal cord are transferred to the shoulder, arms and chest.

The pain in the upper arm and shoulder is often accompanied by the paralysis of the shoulder, marked upper arm weakness and atrophy. This syndrome varies from individual to individual in terms of nerve involvement and presentation.

Parsonage turner Syndrome is also called:

• Brachial Plexopathy
• Acute Brachial Neuropathy
• Parsonage Turner syndrome Idiopathic Brachial Neuritis
• Brachial Plexitis
• Acute Brachial Radiculitis

Parsonage Turner Syndrome Signs

While examining the wrist, arm or hand, the following signs may reveal a problem of the nerves:

• Malformation of the hand or arm
• Trouble in moving the arm, shoulders, or fingers
• Weakness of the hand
• Reduced arm reflexes

Parsonage Turner syndrome Symptoms

There are some distinct symptoms which reveal the occurrence of this disease. These include:

• Numbness of the shoulder arm
• Hyperesthesia
• Shoulder pain
• Muscle Fatigue and Weakness
• Upper Arm pain
• Weakness of the shoulder, wrist or arm
• Muscle wasting and Atrophy
• Paralysis of the shoulder muscles and atrophy

Parsonage Turner Syndrome Causes

Parsonage Turner Syndrome is a form of peripheral neuropathy, which is caused by an inflammatory damage to the brachial plexus, which is a group of nerve bundles which stretch from the spinal cord to the shoulders, hands and arm. The Brachial plexus can be damaged due to a direct injury to the nerve, birth injury, tumor pressure in that area, or impairment due to radiation therapy.

The dysfunction caused to the brachial plexus in the form of Parsonage Turner Syndrome occurs also due to – Inflammatory conditions, exposure to chemical drugs or toxins, or birth defects.

Parsonage Turner Syndrome Disability

Parsonage turner syndrome may cause severe disabilities in the patients. The sufferers may face a traumatic injury, such as jerking of the arm, stab wounds and falling off a ladder, fever followed by an infection and so on. Males are more prone to this disease than females, expect in cases where the disease is a hereditary one.

Parsonage Turner Syndrome HIV

The clinical cases of acute infection with human immunodeficiency virus (HIV) associated with acute Brachial neuritis is very rare. Many of the people who are diagnosed to possess both this infection actually suffer from an acute illness which resembles infectious mononucleosis. There is a significant clinical heterogeneity of the acute phase of HIV infection.

Parsonage Turner Syndrome Long Thoracic Nerve

There are various interpretations regarding the occurrence of the long thoracic nerve. For some, the compression at this site is the cause of this disease. But the most acceptable explanation is that it is caused due to the Parsonage Turner Syndrome. The vast majority of long thoracic nerve palsies represent a variant form of   brachial plexitis or parsonage turner syndrome. The patients who have shoulder pain and weakness are said to have this disorder.

Parsonage Turner Syndrome Lyme Disease

Parsonage Turner syndrome can be caused by many infectious agents. Whenever patients with this disorder come for testing, they should definitely get the Serological tests for Lyme disease performed.   The patients who were earlier tested for this disease, showed clear manifestations of the Lyme disease.

Parsonage Turner Syndrome Diagnosis

Various types of tests may be done to diagnose this disease. The tests performed to diagnose this condition include:

• Nerve Biopsy
• Chest X-Ray
• Electromyogram (EMG)
• Blood tests
• MRI of the head
• Nerve Conduction tests

Parsonage Turner Syndrome Treatment

The treatment procedure is aimed at removing the underlying cause and allowing patient to make use of his arms and shoulders. There were cases when there was no need of treatment, and the patient was cured on its own. But most of the time, the patient has to go through a medical procedure to get cured of this disorder.

Sometimes, pain medications may help. Anti-inflammatory drugs like Prednisone are known to have helped several patients. Anticonvulsants like Phenyton, Carbamazepine, pregabalin and gabapentin is als0 useful. Certain antidepressants such as Nortiptyline and amitriptyline may be consumed to get cured, on the recommendation of a medical expert.

Physical therapy is known to have provided benefits to a lot of sufferers of this disorder. Orthopedic assistance may also increase the ability of the hand and arm. Apart from this, Occupational therapy, Vocational counseling, Occupational changes may also be recommended.

If the nerves are affected, then there is a need to consider the underlying medical problem related to it. Nerve regeneration after an episode is considered normal, but in cases which are not that serious, full recovery may be expected.

Parsonage turner syndrome MRI

Magnetic Resonance Imaging or MRI of the shoulder is done to:

• Spot Rotator Cuff disorders, Impingement
• Find out problems of the shoulder such as Arthritis. An MRI can detect cartilage tears called Labrum in the shoulder.
• It checks unexplained shoulder pain.

MRI is prescribed to check the exact area of pain and so that appropriate treatment may be availed.

Parsonage Turner Syndrome Prognosis

The expectation and the likely outcome depend on the cause related to the disease. There may be cases of partial or complete loss of sensation or movement. The nerve pain may be severe and may persist for some time. Complete recovery is possible if the cause is identified on time and if proper treatment is given.

Parsonage Turner Syndrome causes severe pain in the upper arm and shoulders. It is a curable disease, so you should not panic if you are suffering from this disorder. Just act with alacrity, and go for immediate medical treatment, and you will soon be cured of this disease.

Reference:

http://en.wikipedia.org/wiki/Parsonage-Turner_syndrome

http://www.wrongdiagnosis.com/p/parsonage_turner_syndrome/symptoms.htm?ktrkack=kcplin

http://neurotalk.psychcentral.com/thread72131.html

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002391/

http://emedicine.medscape.com/

http://www.aafp.org/afp/20001101/2067.html

http://www.everydayhealth.com/health-center/parsonage-turner-syndrome.aspx