brachial plexus neuropathy (Parsonage-Turner syndrome)

Etiology

• unknown
• immune-mediated mechanisms have been proposed
• ischemic mechanisms have been proposed

Epidemiology

• men affected 2-3 times more often than women

Clinical manifestations

• onset may follow an upper respiratory tract infection or an immunization
• abrupt onset of severe pain
  • pain involves a variable group of muscles anywhere from the shoulder to the hand
  • the pain generally lasts 1 week
  • after 1 week, the pain gradually diminished
• progressive weakness
  • occurs in same muscles as pain diminishes
  • weakness slowly resolves
• symptoms are bilateral on 30% of patients
• vague sensory abnormalities may be present

Differential diagnosis

• amyotrophic lateral sclerosis (ALS)
  • ALS continues to progress
  • upper motor neuron signs (ALS)
• cervical radiculopathy (radicular pattern)
• Lyme disease (CSF lymphocytosis)

More general terms

• brachial plexopathy
• syndrome

More specific terms

• idiopathic brachial plexitis;

Additional terms

• amyotrophic lateral sclerosis (ALS); Lou Gerig's disease
• Lyme disease