Parsonage Turner Syndrome (PTS)
What is Parsonage Turner syndrome?
Parsonage Turner syndrome (PTS) is a form of neuralgic amyotrophy. It is characterized by sudden pain in the shoulder and upper arm that gets progressively worse over time. The pain will follow the path of a few nerves in the arm.
This condition affects males more than females, with an incidence of about one to three people of every 100,000 per year. This number may be incorrect due to the number of people who go without a diagnosis or are misdiagnosed.
What are the symptoms of Parsonage Turner syndrome?
The major symptom of PTS is a sharp and sudden pain in the shoulder and upper arm. This pain may spread to the neck, lower arm, or hand as well. A very small minority of cases report pain on both sides of the body.
The intense pain can last anywhere from a few hours to a few weeks, but it eventually subsides into duller pain that can last for more than a year. After the pain leaves, the affected area is typically very weak. The level of weakness varies from case to case; some people experience mild weakness while others are nearly paralyzed. The muscle can atrophy as well.
What causes Parsonage Turner syndrome?
PTS is idiopathic, meaning there is no known cause. The suspicion is that something triggers an autoimmune response, resulting in the characteristic symptoms. Possible triggers include infections, surgeries, vaccinations, childbirth, certain medical procedures, injury, strenuous exercise, and certain medical conditions. The issue is that a trigger cannot be found in many cases.
Other medical professionals believe that the cause is a combination of genetic and environmental factors. They believe that there are mutations on one or more genes that result in the characteristic symptoms after exposure to certain environmental factors.
How is Parsonage Turner syndrome diagnosed?
Doctors will first suspect PTS after finding the characteristic symptoms. Further testing may rule out other conditions and confirm a diagnosis. They may use nerve conduction studies, MRIs, X-rays, and an electromyography.
What are the treatments for Parsonage Turner syndrome?
Treatment depends on the specific symptoms that each person experiences. Doctors may prescribe pain medication during the period in which the pain is severe. Afterwards, they will administer co-analgesics. They may also recommend electrical nerve stimulation and applying heat or cold.
After the pain is gone, physical and occupational therapy may be necessary to regain strength in the arm. If they are not effective, surgery is an option.