Parsonage turner - Revision history

Rossdonaldson1: Redirected page to Parsonage-Turner syndrome

2020-08-05T18:23:54Z

Redirected page to Parsonage-Turner syndrome

← Older revision	Revision as of 18:23, 5 August 2020
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		#REDIRECT[[Parsonage-Turner syndrome]]

Fredvarone: Blanked the page

2020-08-02T16:31:49Z

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← Older revision		Revision as of 16:31, 2 August 2020
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	~~==Background==~~
	*Syndrome characterized by sudden onset, severe shoulder pain followed by weakness and sensory loss as pain resolves over the course of days to weeks
	*Also known by many other names including acute brachial neuritis, acute brachial plexitis, idiopathic brachial plexopathy, neuralgic amyotrophy
	*More common in males in the 4th decade of life
	*Can affect any part of the brachial plexus
	**Most commonly affected nerves: long thoracic nerve, suprascapular nerve, axillary nerve, musculocutaneous nerve, radial nerve
	*Up to 1/3 may have bilateral involvement<sup>2</sup>
	*Upper trunk most frequently affected<sup>3</sup>
	*May have preceding viral syndrome
	*Two forms
	**Idiopathic
	**Hereditary

	~~==Clinical Features==~~
	*Severe shoulder girdle pain
	*Weakness, paresthesias, and sensory losses that depend on which nerves are involved
	*Muscle atrophy may develop after several weeks of neuropathy
	*Loss of reflexes
	*Scapular winging


	~~==Differential Diagnosis==~~
	*[[Brachial plexopathy]]
	**Idiopathic
	**Post-infectious
	***Viral
	****[[Epstein-Barr]], [[CMV]], [[influenza]], [[parvovirus]], [[coxsackie]], [[HIV]], [[Polio]]
	***Bacterial
	****[[Lyme]], [[Leptospirosis]], [[TB]], [[Salmonella]]
	**Post-immunization
	**Compressive
	***Neoplasm
	****[[Pancoast tumor]]
	**Post-traumatic
	***Penetrating or blunt neck/shoulder trauma
	***Traction injury
	***Birth trauma
	****[[Erb's palsy]]
	****[[Klumpke's paralysis]]
	**Connective tissue disorders
	**Autoimmune disorders
	***[[Lupus]]
	***[[Polyarteritis nodosa]]
	***[[Temporal arteritis]]
	**Iatrogenic
	***Post-surgical
	***Medication induced
	***Radiation
	**Hereditary Neuralgic Amyotrophy

	*[[Rotator Cuff Injury]]
	*[[Adhesive capsulitis]]
	*[[Calcific tendinitis]]
	*[[Thoracic outlet syndrome]]
	*[[ALS]]
	*[[Poliomyelitis]]

	~~===Upper extremity [[peripheral nerve syndromes]]===~~
	~~====Median Nerve Syndromes====~~
	*[[Median Mononeuropathy (Carpal Tunnel Syndrome)\|Carpal tunnel syndrome]]
	*[[Pronator teres syndrome]]
	*[[Anterior interosseous neuropathy]]

	~~====Ulnar Nerve Syndromes====~~
	*[[Ulnar neuropathy at the elbow and wrist]]

	~~====Radial Nerve Syndromes====~~
	*[[Radial neuropathy at the spiral groove]] (ie. "Saturday night palsy")
	*[[Posterior interosseous neuropathy]]

	~~====Proximal Neuropathies====~~
	*[[Suprascapular neuropathy]]
	*[[Long thoracic neuropathy]]
	*[[Axillary neuropathy]]
	*[[Spinal accessory neuropathy]]
	*[[Musculocutaneous neuropathy]]

	~~====Other====~~
	*[[Brachial plexopathy]]
	*[[Cervical radiculopathy]]


	~~==Evaluation==~~
	*Plain films if there is history of trauma
	*Consider [[MRI]] in the ED to rule out acute cervical spine pathology
	*Outpatient brachial plexus [[MRI]]/MRN
	*Outpatient EMG - should be performed at least 3 weeks after symptom onset to show findings<sup>4</sup>

	~~==Management==~~
	*Early conservative management
	**NSAIDs, sling, physical therapy
	**Antiviral medications if etiology is viral in nature
	**Oral steroids recommended by some in early disease for pain<sup>3,4</sup>
	*Operative management considered for space occupying lesions or if no recovery is seen in 6-9 months
	**Nerve decompression, neurolysis, neurorrhaphy, nerve transplant/grafting, muscle/tendon transplant/grafting

	~~==Disposition==~~
	*Depends on etiology - acute traumatic injuries may need urgent or emergent surgery
	*Most idiopathic cases can be discharged with neurology/orthopedics follow up
	*Full recovery can take up to 2-3 years

	~~==See Also==~~


	~~==External Links==~~


	~~==References==~~
	~~<references/>~~
	~~# Feinberg et al. Parsonage-Turner Syndrome. HSSJ. 2010;6:199-205.~~
	~~# Misamore et al. Parsonage-Turner Syndrome (Acute Brachial Neuritis). Journal of Bone and Joint Surgery. 1996;78(9)1405-1408.~~
	~~# Moghekar et al. Brachial Plexopathies: Etiology, Frequency, and Electrodiagnostic 4. Localization. Journal of Clinical Neuromuscular Disease. 2007;9(1):243-247.~~
	# Ortiz Torres M et al. Brachial Plexitis (Parsonage Turner Syndrome, Brachial Neuropathy, Brachial Radiculitis) [Updated 2020 Apr 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NBK448114/

Fredvarone: Created page with "==Background== Syndrome characterized by sudden onset, severe shoulder pain followed by weakness and sensory loss as pain resolves over the course of days to weeks Also know..."

2020-08-02T16:30:06Z

Created page with "==Background== *Syndrome characterized by sudden onset, severe shoulder pain followed by weakness and sensory loss as pain resolves over the course of days to weeks *Also know..."

New page

==Background==
*Syndrome characterized by sudden onset, severe shoulder pain followed by weakness and sensory loss as pain resolves over the course of days to weeks
*Also known by many other names including acute brachial neuritis, acute brachial plexitis, idiopathic brachial plexopathy, neuralgic amyotrophy
*More common in males in the 4th decade of life
*Can affect any part of the brachial plexus
**Most commonly affected nerves: long thoracic nerve, suprascapular nerve, axillary nerve, musculocutaneous nerve, radial nerve
*Up to 1/3 may have bilateral involvement2
*Upper trunk most frequently affected3
*May have preceding viral syndrome
*Two forms
**Idiopathic
**Hereditary

==Clinical Features==
*Severe shoulder girdle pain
*Weakness, paresthesias, and sensory losses that depend on which nerves are involved
*Muscle atrophy may develop after several weeks of neuropathy
*Loss of reflexes
*Scapular winging

==Differential Diagnosis==
*[[Brachial plexopathy]]
**Idiopathic
**Post-infectious
***Viral
****[[Epstein-Barr]], [[CMV]], [[influenza]], [[parvovirus]], [[coxsackie]], [[HIV]], [[Polio]]
***Bacterial
****[[Lyme]], [[Leptospirosis]], [[TB]], [[Salmonella]]
**Post-immunization
**Compressive
***Neoplasm
****[[Pancoast tumor]]
**Post-traumatic
***Penetrating or blunt neck/shoulder trauma
***Traction injury
***Birth trauma
****[[Erb's palsy]]
****[[Klumpke's paralysis]]
**Connective tissue disorders
**Autoimmune disorders
***[[Lupus]]
***[[Polyarteritis nodosa]]
***[[Temporal arteritis]]
**Iatrogenic
***Post-surgical
***Medication induced
***Radiation
**Hereditary Neuralgic Amyotrophy

*[[Rotator Cuff Injury]]
*[[Adhesive capsulitis]]
*[[Calcific tendinitis]]
*[[Thoracic outlet syndrome]]
*[[ALS]]
*[[Poliomyelitis]]

===Upper extremity [[peripheral nerve syndromes]]===
====Median Nerve Syndromes====
*[[Median Mononeuropathy (Carpal Tunnel Syndrome)|Carpal tunnel syndrome]]
*[[Pronator teres syndrome]]
*[[Anterior interosseous neuropathy]]

====Ulnar Nerve Syndromes====
*[[Ulnar neuropathy at the elbow and wrist]]

====Radial Nerve Syndromes====
*[[Radial neuropathy at the spiral groove]] (ie. "Saturday night palsy")
*[[Posterior interosseous neuropathy]]

====Proximal Neuropathies====
*[[Suprascapular neuropathy]]
*[[Long thoracic neuropathy]]
*[[Axillary neuropathy]]
*[[Spinal accessory neuropathy]]
*[[Musculocutaneous neuropathy]]

====Other====
*[[Brachial plexopathy]]
*[[Cervical radiculopathy]]

==Evaluation==
*Plain films if there is history of trauma
*Consider [[MRI]] in the ED to rule out acute cervical spine pathology
*Outpatient brachial plexus [[MRI]]/MRN
*Outpatient EMG - should be performed at least 3 weeks after symptom onset to show findings4

==Management==
*Early conservative management
**NSAIDs, sling, physical therapy
**Antiviral medications if etiology is viral in nature
**Oral steroids recommended by some in early disease for pain3,4
*Operative management considered for space occupying lesions or if no recovery is seen in 6-9 months
**Nerve decompression, neurolysis, neurorrhaphy, nerve transplant/grafting, muscle/tendon transplant/grafting

==Disposition==
*Depends on etiology - acute traumatic injuries may need urgent or emergent surgery
*Most idiopathic cases can be discharged with neurology/orthopedics follow up
*Full recovery can take up to 2-3 years

==See Also==

==External Links==

==References==
<references/>
# Feinberg et al. Parsonage-Turner Syndrome. HSSJ. 2010;6:199-205.
# Misamore et al. Parsonage-Turner Syndrome (Acute Brachial Neuritis). Journal of Bone and Joint Surgery. 1996;78(9)1405-1408.
# Moghekar et al. Brachial Plexopathies: Etiology, Frequency, and Electrodiagnostic 4. Localization. Journal of Clinical Neuromuscular Disease. 2007;9(1):243-247.
# Ortiz Torres M et al. Brachial Plexitis (Parsonage Turner Syndrome, Brachial Neuropathy, Brachial Radiculitis) [Updated 2020 Apr 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NBK448114/

Parsonage turner - Revision history

Rossdonaldson1: Redirected page to Parsonage-Turner syndrome

Fredvarone: Blanked the page

Fredvarone: Created page with "==Background== *Syndrome characterized by sudden onset, severe shoulder pain followed by weakness and sensory loss as pain resolves over the course of days to weeks *Also know..."

Fredvarone: Created page with "==Background== Syndrome characterized by sudden onset, severe shoulder pain followed by weakness and sensory loss as pain resolves over the course of days to weeks Also know..."