ABSTRACT
Rationale: Parsonage-Turner syndrome is a rare syndrome of unknown etiology, affecting mainly the lower motor neurons of the brachial plexus. Chikungunya fever is a mosquito-borne viral disease characterized by acute fever and polyarthritis/polyarthralgia. Patient concerns: A 54-year-old Brazilian male patient who presented with a 2-day history of fever (temperature 38.8 °C), arthralgia, erythematous rash, diffuse osteomuscular pain and headache, which evolved into left shoulder pain associated with morning stiffness. Diagnosis: Parsonage-Turner syndrome and chikungunya fever. Interventions: Symptomatic treatment (a combination of short-acting dypirone (500 mg every 6 h) and slow-release opioids (tramadol 100 mg every 4 h) and physiotherapy/rehabilitation with improvement. Outcomes: The patient was improved and discharged, remaining with symptomatic treatment and physiotherapy/rehabilitation. Lessons: To the best of our knowledge, there were no reports of Parsonage-Turner syndrome following chikungunya virus infection. Awareness of the possibility of this rare association is important. The present case report highlights the importance of awareness of this association as a new cause of morbidity in patients with chikungunya virus infection.
ABSTRACT
Rationale: Parsonage-Turner syndrome is a rare syndrome of unknown etiology, affecting mainly the lower motor neurons of the brachial plexus. Chikungunya fever is a mosquito-borne viral disease characterized by acute fever and polyarthritis/polyarthralgia. Patient concerns: A 54-year-old Brazilian male patient who presented with a 2-day history of fever (temperature 38.8 °C), arthralgia, erythematous rash, diffuse osteomuscular pain and headache, which evolved into left shoulder pain associated with morning stiffness. Diagnosis: Parsonage-Turner syndrome and chikungunya fever. Interventions: Symptomatic treatment (a combination of short-acting dypirone (500 mg every 6 h) and slow-release opioids (tramadol 100 mg every 4 h) and physiotherapy/rehabilitation with improvement. Outcomes: The patient was improved and discharged, remaining with symptomatic treatment and physiotherapy/rehabilitation. Lessons: To the best of our knowledge, there were no reports of Parsonage-Turner syndrome following chikungunya virus infection. Awareness of the possibility of this rare association is important. The present case report highlights the importance of awareness of this association as a new cause of morbidity in patients with chikungunya virus infection.
ABSTRACT
<p><b>Objective:</b> Parsonage-Turner syndrome is a peripheral neuropathy characterized by acute onset shoulder pain, myalgia, and sensory disturbances. The present report discusses a rare case of Parsonage-Turner syndrome and highlights the importance of accurate history recording and thorough physical examination for the diagnosis of the disease in rural areas.</p><p><b>Patient:</b> A 28-year-old woman presented to our clinic with acute bilateral shoulder pain and difficulty moving her right arm. A diagnosis of Parsonage-Turner syndrome was suspected based on the progression of symptoms, severity of pain, and lack of musculoskeletal inflammation. The diagnosis was confirmed by neurological specialists, and the patient was treated with methylprednisolone, after which her symptoms gradually improved.</p><p><b>Discussion:</b> The differential diagnosis of shoulder pain is complicated due to the wide variety of conditions sharing similar symptoms. Accurate history recording and thorough physical examination are required to differentiate among conditions involving the central nerves, peripheral nerves, and nerve plexuses.</p><p><b>Conclusion:</b> Although the symptoms of Parsonage-Turner syndrome vary based on disease progression and the location of impairment, proper diagnosis of acute shoulder pain without central neurological symptoms can be achieved in rural areas via thorough examination.</p>
ABSTRACT
La espondilodiscitis por Streptococcus agalactiae es infrecuente, ya que éste es un microrganismo clásicamente patógeno en el periodo gestacional y perinatal. Sin embargo se está produciendo un aumento en la incidencia de infecciones invasivas en adultos inmunocompetentes. Asimismo, el síndrome de Parsonage-Turner o neuritis braquial aguda es una entidad clínica poco frecuente, caracterizada por dolor y debilidad muscular de la extremidad superior. Presentamos el caso de un varón de 50 años con bacteriemia por S. agalactiae, espondilodiscitis cervical y neuritis braquial secundaria y revisamos la literatura.
Spondylodiscitis caused by streptococcus agalactiae has been traditionally considered an infrequent disease since S. agalactiae is a pathogenic microorganism conventionally in gestational and perinatal period. However it is producing an increase in the incidence of invasive infections in immunocompetent adults. Also Parsonage-Turner syndrome or brachial radiculitis is a rare disorder and is characterized by pain followed by weakness in the distribution of the upper brachial plexus. We report one case and review the literature.
ABSTRACT
Se presenta el caso de un varón de 17 años con diagnóstico de síndrome de Parsonage-Turner recidivante en brazo derecho. En su historial clínico se diagnosticó neuralgia amiotrófica de miembro superior en tres ocasiones anteriores, con clínica semejante en cada uno de los episodios, aunque alternándose el miembro superior afecto. Estuvo en tratamiento en los Servicios de Rehabilitación de dos centros hospitalarios. A la exploración física en cada recidiva presenta dolor intenso en el hombro y brazo, y pérdida de fuerza en escápula y miembro superior afecto. El objetivo de su tratamiento combina tratamiento del dolor y, junto con fisioterapia, luchar contra la atrofia muscular que presenta. El paciente evolucionó favorablemente en cada uno de los episodios que presentó y, en la actualidad, se muestra asintomático y dado de alta en el servicio de Rehabilitación.
We present the case of a 17-year-old male whose diagnosis is Parsonage-Turner syndrome relapsing in the right arm. In his medical record, he was diagnosed as having amyotrophic neuralgia of the upper limb in three previous occasions. The diagnosis was similar in all episodes, although the affected upper limb was alternating. He was treated in the Rehabilitation Services of two hospitals. At physical examination, in every relapse, he showed acute pain in both, shoulder and arm, and loss of strength in the shoulder blade and the affected upper limb. The aim of his treatment combines the healing of the pain and, together with physiotherapy, fighting against muscular atrophy. The patient evolved favourably in each of the episodes. Nowadays, he does not show any symptom, and he has been discharged from the rehabilitation service.
Subject(s)
Adolescent , Humans , Male , Brachial Plexus Neuritis/diagnosis , PhenotypeABSTRACT
This article presents six cases of Parsonage-Turner syndrome with corticosteroid therapy in the muscle weakness phase. Three cases did not receive injected steroids after the onset of muscle weakness, and were classified as Group 1. The other three cases received injected steroid from just after muscle weakness onset, and were classified as Group 2. This article has a small study group of six cases, but is the first case study about the efficacy of steroids in the muscle weakness phase, showing a better treatment result when steroids were injected during the muscle weakness period. We report these findings, together with a review of the literature.