Parsonage Turner syndrome is a rare neurological disorder of the central nervous system, with MRI findings indicating partial or complete muscle weakness. In this article, we discuss the Electrophysiologic evidence and Clinical presentation of the disorder and parsonage turner treatment. The findings of this article may be useful for you if you suspect that you have this condition. You can also follow the links below to find more information about the disorder.
MRI Findings
MRI findings are critical for the diagnosis of Parsonage-Turner syndrome. It allows the physician to rule out more common causes of shoulder pain. MRI can detect signal abnormalities affecting the denervation of the shoulder girdle and exclude the presence of structural abnormalities causing similar changes. Also, MRI findings in this patient also include atrophy of the supraspinatus and infraspinatus muscles.
MRI findings of parsonage turner disease include hypoplasia of the vertebral arteries, neuropathy, and a variety of other conditions. Parsonage-Turner syndrome may be unilateral or bilateral or may occur with involvement of the phrenic nerve. Treatment for this disorder is palliative, which may involve analgesics for the pain and physical therapy for weakness. This syndrome is usually self-limiting.
A thorough physical examination is essential in establishing the correct diagnosis of PTS. MRI findings of the affected muscles include diffuse muscle edema, fatty infiltration, and weakened muscles. The radiologists may be the first to make the diagnosis, but it is still vital to confirm the condition. A proper diagnosis can prevent unnecessary surgical interventions. So, if you suspect PTS, don’t hesitate to seek medical attention.
Electrophysiologic Evidence Of Parsonage Turner Syndrome
Parsonage-Turner Syndrome (PTS) is a neurologic disorder of the peripheral nervous system that characterize by acute onset of severe pain in the shoulder, most often in the early morning. It lasts for at least four weeks but may subside in as little as 24 hours in some cases. In patients with this syndrome, the symptomatology includes weakness and motor involvement of the upper extremity muscles. Depending on the severity of the symptoms, it may take several months or even years for the patient to recover.
In patients with PT, muscle strength is generally normal in the wrists, hand, and biceps muscles. Pain management accomplishes with opiates, NSAIDs, and neuroleptics. Some patients may treat with acupuncture or transcutaneous electrical nerve stimulation. While oral steroids are recommended in some cases, the literature supporting their efficacy is limited. Occasionally, immunotherapy administers to improve neurological symptoms.
Clinical Presentation
Parsonage-Turner syndrome is a rare but debilitating disorder characterized by muscle weakness and a sudden onset of pain in the upper arm. The symptoms of Parsonage-Turner syndrome can be triggered by a wide range of causes, including infections, injuries, or surgical procedures. It often goes undiagnosed due to the similar symptoms of cervical spondylosis, such as headaches and muscle weakness.
Although Parsonage-Turner syndrome has several clinical features, a scapular winging pattern and loss of mobility are associated with the onset of symptoms. The median time from beginning to diagnosis is approximately 10.5 weeks. However, Parsonage-Turner syndrome doesn’t diagnose, as it may be difficult to distinguish from other shoulder disorders, such as acromioclavicular joint disorder. For this reason, alternative differential diagnoses are present in table 1.
Initial descriptions of PTS date back to the late 1800s. In the first reports by Drs. Parsonage and Turner classified the disorder as ‘hereditary neuralgic amyotrophy‘ or ‘amyotrophic neuropathy.’ However, the disease doesn’t always associate with such a diagnosis and often requires increased vigilance in the diagnosis. In addition to MRI, electromyography and a full history of triggering events help exclude other disease causes.
Treatment
The Parsonage-Turner treatment depends on the cause of the condition. Also, the disorder believes in occurring due to an earlier virus infection. During the illness, the immune system develops antibodies to the virus’s coat protein. These antibodies recognize the same structure in the brachial plexus nerve as a virus. Therefore, the body incorrectly identifies the nerve protein as a virus. As a result, the patient develops pain and weakness in the arm.
There are several types of treatments for Parsonage-Turner syndrome. Initially, conservative therapies are used to treat the condition. Electrodiagnostic tests, such as nerve conduction studies can help localize the root level. While conservative therapies are the gold standard, targeted steroid injections can be used to treat the condition. However, a patient must have experienced symptoms for at least three weeks before undergoing any form of treatment.
