Ver el código de «Parsonage-Turner syndrome»

==Background==
[[File:Gray808.png|thumb|Right brachial plexus with its short branches, viewed anteriorly.]]
*Syndrome characterized by sudden onset, severe shoulder pain followed by [[weakness]] and [[numbness|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 [[numbness|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==
{{Causes of brachial plexopathy}}
{{Upper extremity peripheral nerve syndromes}}

==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]] or magnetic resonance neurography
*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==
*[[Peripheral nerve syndromes]]

==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/

[[Category:Neurology]]
[[Category:Orthopedics]]