Parsonage Turner Syndrome

Abstract

The potential causes of shoulder pain are numerous, ranging from trauma, to disease, to hereditary issues. Here we report on a rare, but emerging potential culprit. Parsonage-Turner Syndrome (PTS) is a neurologic disorder affecting peripheral nerves, usually the upper trunk of the brachial plexus. It is generally characterized by the rapid onset of severe shoulder pain and eventual muscle wasting and weakness in the affected area. PTS is of unknown etiology, but postulated causative factors include disease, heredity, medicines, trauma, and surgery. A definitive diagnosis of PTS is difficult as symptoms overlap with other shoulder ailments such as rotator cuff pathologies, impingements, adhesive capsulitis, cervical spondylosis, and suprascapular neuropathy. Ultimately patient history, MRI, and EMG are necessary to confirm PTS. Conservative treatment, including pain management and physical therapy, is key. Most patients progressively recover within a period of 3 years. The present case involves a 22 year-old white male and former collegiate athlete. The patient underwent a surgical procedure in order to cosmetically correct an injury sustained previously in an automobile accident, and presented with severe left shoulder pain two days post-op. Atrophy, and weakness of infraspinatus and supraspinatus muscles were observed three months after surgery, and EMG was positive for suprascapular nerve dysfunction. The patient was treated with oral steroids and hydrocodone, and underwent physical therapy for a year. Most of the strength and bulk in both muscles was regained three years after initial presentation, but he failed to have a full recovery.