Parsonage Turner syndrome, a case report

Abstract

Parsonage-Turner syndrome (PTS), brachial plexitis or brachial neuritis is a rare pathology, with an incidence of approximately 3 cases per 100,000 inhabitants of unknown etiology, although in some cases triggering factors such as bacterial infections have been found and it has been related to systemic diseases.²

Its classic characteristic is unilateral omalgia, of sudden onset, disabling, with subsequent muscle weakness, which is accentuated in movements such as elevation, abduction and external rotation of the affected limb. It has been observed that in PTS the peripheral nerves most involved are the long thoracic, axillary, musculocutaneous and suprascapular nerves. Several phases have been described in PTS.

The neuritis phase, the paralysis and muscle atrophy phase, and the recovery phase. In most cases no sequelae have been reported, however, permanent motor deficits may be observed in some patients. ^2,3,4,5,6

This is a clinical case of a 67-year-old female patient, with a history of DM2, who consults for acute onset left shoulder pain associated with loss of strength, functional limitation of the shoulder and alterations of sensitivity, which was preceded by periodontal infection in the ipsilateral lower jaw, which drained spontaneously for which she did not receive antibiotic treatment, and after performing an MRI, it was found alterations in the intensity of the supraspinatus, infraspinatus and subscapularis tendinopathy, in addition to electromyography with chronic signs of chronic reinnervation and fibrillation in chronic reinnervation, After performing an MRI, alterations in the intensity of the supraspinatus and infraspinatus muscles and subscapularis tendinopathy were found, in addition to electromyography with chronic signs of chronic reinnervation and fibrillation at rest of the supraspinatus, deltoid and left biceps muscles, without motor involvement of the same, thus reaching the diagnosis of a Parsonage Turner syndrome, which responded positively to treatment with transcutaneous nerve stimulation (TENS).