There may be many reasons for a painful condition in the arms and shoulders or the upper extremity in general resulting in reduced range of motion due to pain and other symptoms. One such condition is Parsonage Turner Syndrome also known by the name of Brachial Plexopathy.
What is Parsonage Turner Syndrome or Brachial Plexopathy?
Parsonage Turner Syndrome or Brachial Plexopathy is a medical condition in which there is pain, reduced motion, and/or reduced sensation in arms and shoulders as a result of a nerve issue. Parsonage Turner Syndrome is a type of peripheral neuropathy which occurs due to damage to brachial plexus, which is an area on either side of neck where nerve roots from spinal cord branch out into nerves of each arm.
Causes of Parsonage Turner Syndrome or Brachial Plexopathy
An injury or impairment to brachial plexus is usually as a result of some sort of direct injury to the nerve like some sort of a stretching injury to include birth trauma, compression due to tumors in the area, etc. can cause Parsonage Turner Syndrome or Brachial Plexopathy.
Brachial Plexus Dysfunction Can Also Occur Due To:
- Birth defects putting pressure on neck areas.
- Exposure to various toxins or chemicals.
- Use of general anesthesia for surgical procedures.
- Inflammatory conditions.
Symptoms of Parsonage Turner Syndrome or Brachial Plexopathy
Some of the common symptoms of Parsonage Turner Syndrome or Brachial Plexopathy are:
- Numbness of shoulders.
- Pain in shoulders.
- Tingling, burning, or abnormal sensations in the affected area.
- Weakness of shoulder and hands.
Diagnosis of Parsonage Turner Syndrome or Brachial Plexopathy
Examination of the hands and wrists will reveal a problem with nerves of brachial plexus. Other signs can be:
- Deformity of hands
- Difficulty with shoulder or hand motions
- Diminished reflexes in the hands
- Muscle wasting.
A detailed history is often helpful in determining the cause of Parsonage Turner Syndrome or Brachial Plexopathy. The most important factor is the age and gender of the affected individual as some brachial plexus issues are more common in set of individuals.
Other Investigations That May Be Done For Confirmatory Diagnosis Are:
- Blood draws
- Chest x-ray
- EMG
- MRI of head, neck, shoulder
- Nerve conduction velocity tests
- Ultrasound.
Treatment for Parsonage Turner Syndrome or Brachial Plexopathy
The main aim of treatment is to correct the underlying issue causing Parsonage Turner Syndrome or Brachial Plexopathy. There are cases, where treatment for it is not required as the condition resolves on its own.
- To control the symptoms of pain resulting from Parsonage Turner Syndrome, over-the-counter or prescription pain medications can be given.
- Physical therapy is helpful to maintain strength of the muscle in patients suffering from it.
- Referral to Orthopedics can be made to assist the patient suffering from Brachial Plexopathy in increasing range of motion of the hands with usage of braces, splints, etc.
- In some cases local nerve blocks are also done to control pain.
- In cases of severe nerve compression causing symptoms, then surgery may be required to treat Parsonage Turner Syndrome or Brachial Plexopathy.
- Vocational counseling, job retraining, or other measures are done.
Prognosis of Parsonage Turner Syndrome or Brachial Plexopathy
The prognosis of Parsonage Turner Syndrome or Brachial Plexopathy is made in a case to case basis. The prognosis is generally good if the diagnosis of it is made and appropriately treated. In some cases, the nerve pain may persist for quite some time even after treatment.
Some of the Complications of Parsonage Turner Syndrome or Brachial Plexopathy are:
- Deformity of hand or arm
- Partial or complete paralysis of the arm
- Loss of sensation in the arm or hands.
- Cleveland Clinic. (2020). Parsonage Turner Syndrome. https://my.clevelandclinic.org/health/diseases/17797-parsonage-turner-syndrome
- Mayo Clinic. (2021). Brachial Plexopathy https://www.mayoclinic.org/diseases-conditions/brachial-plexopathy/symptoms-causes/syc-20350216
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