Parsonage Turner syndrome

Información en español Title

Other Names:

Acute brachial neuritis; Acute brachial neuritis syndrome; Acute brachial radiculitis syndrome; Acute brachial neuritis; Acute brachial neuritis syndrome; Acute brachial radiculitis syndrome; Acute shoulder neuritis; Idiopathic neuralgic amyotrophy See More

Categories:

Nervous System Diseases

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Symptoms Symptoms

PTS is usually characterized by the sudden onset of severe pain in the shoulder and upper arm, which is often described as sharp or throbbing. In some cases, the pain may extend to the neck, lower arm and/or hand on the affected side. Rarely, both sides of the body are involved. Affected people typically experience constant pain that may become worse with movement. Intense pain can last from a few hours to several weeks at which point the pain usually begins to subside; however, mild pain may continue for a year or longer.^[1]^[2]

As the pain subsides, it is typically replaced by progressive (worsening over time) weakness of the affected area, ranging from mild weakness to nearly complete paralysis. Affected people may also experience muscle wasting (atrophy); absent or reduced reflexes; and/or loss of sensation. In some cases, nerves and muscles outside of the shoulder and upper arm region may be affected, as well.^[1]^[2]

Last updated: 6/15/2017

The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below.

Signs and Symptoms	Approximate number of patients (when available)
Arthralgia	Very frequent (present in 80%-99% of cases)
EMG abnormality	Very frequent (present in 80%-99% of cases)
Polyneuropathy	Very frequent (present in 80%-99% of cases)
Paresthesia	Frequent (present in 30%-79% of cases)
Scapular winging	Frequent (present in 30%-79% of cases)
Sprengel anomaly	Frequent (present in 30%-79% of cases)
Acrocyanosis	Occasional (present in 5%-29% of cases)
Cleft palate	Occasional (present in 5%-29% of cases)
Narrow mouth	Occasional (present in 5%-29% of cases)
Neurological speech impairment	Occasional (present in 5%-29% of cases)
Respiratory insufficiency	Occasional (present in 5%-29% of cases)
Round face	Occasional (present in 5%-29% of cases)
Sleep disturbance	Occasional (present in 5%-29% of cases)

Last updated: 6/1/2017

Cause Cause

The exact cause of PTS is unknown. Researchers suspect that most cases are due to an autoimmune response following exposure to an illness or environmental factor. In many cases, no triggering event or underlying cause can be identified. Factors known to trigger PTS include:^[1]^[2]

Infections (both viral and bacterial)
Surgery
Vaccinations
Childbirth
Certain medical procedures, such as a spinal tap or imaging studies that require administration of radiologic dye
Strenuous exercise
Certain medical conditions, including connective tissue disorders and autoimmune disorders
Injury

Some researchers believe that PTS is a multifactorial condition, which means that it is caused by both environmental and genetic factors. In this case, a person may have a genetic susceptibility to PTS due to one or more genes, but won't develop the condition unless they are exposed to certain environmental triggers (such as those listed above).^[1]^[2]

Last updated: 6/15/2017

Inheritance Inheritance

PTS, which is also known as idiopathic neuralgic amyotrophy, is not inherited. However, the inherited form of neuralgic amyotrophy called hereditary neuralgic amyotrophy is passed down through families in an autosomal dominant manner.^[3]

Last updated: 6/15/2017

Diagnosis Diagnosis

A diagnosis of PTS is often suspected based on the presence of characteristic signs and symptoms. Specialized tests may be recommended to further investigate the shoulder pain and/or muscle weakness and to rule out other conditions that can cause similar features. These tests may include nerve conduction studies (tests that determine the ability of a specific nerve to relay a message to the brain), electromyography, magnetic resonance imaging (MRI scan), and/or an X-ray.^[1]^[2]

Last updated: 6/15/2017

Treatment Treatment

Treatment for PTS varies based on the signs and symptoms present in each person.

Pain medications may be prescribed depending on the severity of the nerve pain. After the acute phase, different medications known as co-analgesics may be administered. Such medications include gabapentin, carbamazepine, and amitryptiline. These drugs specifically treat nerve pain. Other techniques for pain management include application of heat or cold and transcutaneous electrical nerve stimulation (a method of pain relief in which a special device transmits low-voltage electrical impulses through electrodes on the skin to an area of the body that is in pain).^[1]^[2]

Many people with PTS undergo physical therapy and/or occupational therapy to maintain muscle strength and range of motion of affected joints once the pain begins to subside. Surgeries such as nerve grafting or tendon transfer to restore movement and function to the shoulder muscles and joint may be considered if other treatment options are not effective.^[1]^[2]

Last updated: 6/15/2017

Prognosis Prognosis

The long-term outlook (prognosis) for people with PTS varies. Some people may only experience a single episode of pain and fully recover the strength and functionality of their shoulder, while others have multiple episodes throughout their life. It has been reported that approximately 80% of affected people recover within 2 years of the start of symptoms and approximately 90% recover within 3 years. Traditionally, it was believed that most affected people would recover around 70-90% of their original strength and function level, but more recent research suggests that long-term complications are more common than previously reported. People with bilateral (affecting both sides of the body) involvement or multiple episodes are more likely to have a poor prognosis.^[2]^[1]

Last updated: 6/15/2017

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Organizations Organizations

Nonprofit support and advocacy groups bring together patients, families, medical professionals, and researchers. These groups often raise awareness, provide support, and develop patient-centered information. Many are the driving force behind research for better treatments and possible cures. They can direct people to research, resources, and services. Many groups also have experts who serve as medical advisors. Visit their website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

The Center for Peripheral Neuropathy
Department of Neurology
University of Chicago
5841 S. Maryland Ave
MC 2030
Chicago, IL 60637
Website: http://peripheralneuropathycenter.uchicago.edu/
The Foundation for Peripheral Neuropathy
485 Half Day Road
Suite 350
Buffalo Grove, IL 60089
Telephone: +1-877-883-9942
Fax: +1-847-883-9960
E-mail: info@tffpn.org
Website: https://www.foundationforpn.org

Organizations Providing General Support

American Autoimmune Related Diseases Association (AARDA)
22100 Gratiot Avenue Eastpointe
East Detroit, MI 48201-2227
Toll-free: 800-598-4668
Telephone: 586-776-3900
Fax: 586-776-3903
E-mail: aarda@aarda.org
Website: https://www.aarda.org/

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Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
The National Institute of Neurological Disorders and Stroke (NINDS) collects and disseminates research information related to neurological disorders. Click on the link to view information on this topic.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
PubMed is a searchable database of medical literature and lists journal articles that discuss Parsonage Turner syndrome. Click on the link to view a sample search on this topic.

GARD Answers GARD Answers

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

About 3 months following the onset of Parsonage-Turner Syndrome, I developed numbness in my lower body. Gradually over the course of 8 weeks, about 90% of the sensation in my lower body returned. The Parsonage-Turner also damaged my esophagus and one vocal cord. It's been about 8 years and I continue to have the numbness and tingling in my feet. Is it possible that the Parsonage-Turner is causing the persistent neuropathy in my lower body? See answer
I have been recovering from Parsonage Turner syndrome for years. I still have some pain, the fatigue is still with me and my quality of life is compromised. Can this develop into something else? Also, is it normal that I still have fatigue after 5 plus years? See answer

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