Parsonage-Turner Syndrome

shoulder pain
Case Report and discussion prepared by Sidra Ghafoor, Drexel University College of Medicine Class of 2013.

Case: 65 yr old male presents with painful weakness, wating and tingling in the right arm.

When did it all begin? Three months ago patient experienced sudden onset severe pain down his neck accompanied by a tingling sensation in his right forearm and thumb. There was no apparent cause for his symptoms (i.e. no trauma). After 3-4 weeks, his pain miraculously disappeared! Unfortunately, once the pain subsided, he began experiencing weakness in the right shoulder/upper arm and right hand.

Physical Exam (*all findings pertain to patient’s right side*)

  • Muscle Bulk/Tone: Atrophy of supraspinatous, infraspinatus, deltoid, and biceps          
  • Muscle Strength
    • Weakness of supraspinatus, infraspinatus, biceps, brachioradialis, and pronator teres
    • Normal strength of Rhomboids, trceps, wrist and hand muscles    
  • Sensation: Numbness over lateral arm, forearm, and anatomic snuffbox             
  • Reflexes: Absent biceps and brachioradialis

Parsonage-Turner Syndrome (Neuralgic Amyotrophy, Brachial Neuritis)

    • Incidence: relatively rare (1-2 cases per 100,000)
    • Sex/Age
    • Cause: unknown etiology – but linked to recent illness/events:
    • Clinical Correlation
      • Affects Lower Motor Neurons of brachial plexus and/or individual nerves or nerve branches (this explains the patchy clinical findings on exam).  The suprascapular nerve long thoracic nerve, phrenic nerve, and branches of the median nerve are nearly always affected:
Brachial neuritis, wasting of the shoulder girdle muscles

Brachial neuritis, wasting of the shoulder girdle muscles innervated by the suprascapular nerve.

Brachial neuritis, winged scapula

Brachial neuritis, winged scapula from involvement of the long thoracic nerve

Brachial neuritis, elevated hemidiaphragm from involvement of the phrenic nevre

Brachial neuritis, elevated hemidiaphragm from involvement of the phrenic nerve

  • Clinical Sequence of Events
    • (1) Acute onset severe unilateral pain (throbbing, aching) in shoulder/arm
    • (2) Pain resolves within 1-3 weeks
    • (3) weakness/wasting of involved muscles and variable sensory impairment
  • Prognosis
    • Full recovery in majority of cases by 6 months to 1 year
    • Rarely recurrent (exception: familial neuralgic amyotrophy is typically recurrent)
  • Diagnosis
    • Clinical Clues: acute onset, pain followed by weakness & impaired sensation, no preceding trauma
      • aggravated by movement but not by coughing, sneezing, laughing (this helps to differentiate it from Cervical Radiculopathy – in which pain is aggravated by coughing/sneezing/laughing)
    • Physical Exam Clues: patchy involvement of nerves
      • affected arm is internally rotated and adducted at shoulder.  flexed at elbow.
    • EMG: localizes lesion to brachial plexus and differentiates it from Peripheral Focal Neuropathy and Cervical Radiculopathy
      • 1 wk after onset: Loss of sensory and motor amplitudes with relatively normal conduction velocity
      • 2-3 wks after onset: shows denervation (fibrillations, positive sharp waves, and/or motor unit potential changes) in affected muscles
  • Management

39 thoughts on “Parsonage-Turner Syndrome”

  1. My husband is 70 years old. In Oct/Nov 2013, he began having severe left shoulder pain and then his shoulder became weak. His first neurologist ruled out cervical spine problems and diagnosed him with brachial neuritis. In December, his shoulder had no movement at all, but he did have some elbow/hand movement. Within a week of starting outpatient therapy, he then developed a weaker arm and wrist drop. He went to IP rehabilitation per his neurologist’s request but was only there temporarily because he was able to get around fine. He was having some personality issues with his neurologist and changed to another neurologist. His shoulder began to show some improvement but his wrist did not get any better. Then in April, he lost complete use of his forearm and hand, and he could no longer bend his arm. His shoulder regressed as well. His neurologist put him on some various meds that made my husband loopy and I also noticed his face began to swell. He now has developed left hip weakness, and he now cannot tolerate lying down. He says he feels like he can’t breathe when he lies down (he had pneumonia approximately 1 month ago, but his lungs are clear now). Last week, he went to the ER with severe swelling in his legs. He also has diabetes. They sent him back to inpatient rehabilitation. He can not lay back at all and sleeps sitting up. He does not have CHF, he does not have fluid in his lungs, and he does not have kidney problems. He reports it fills like his lungs are filling up if he lays flat and that he can’t breathe. Lung x-rays have only shown atelectasis. One of his therapists thinks his phrenic nerve has been affected, but my husband’s neurologist didn’t say anything when I asked him about it. My husband has seen numerous doctors over the past 6 months, and they keep running all these tests on him and can’t really find any answers. Can you recommend someone in Dallas, Texas that would be familiar with this condition?

    Reply

    • Sorry to hear about this complicated problem. It certainly sounds like an autoimmune issue, perhaps something like MMN affecting multiple nerves, and he might benefit from an anti-immune therapy like IVIG. I agree with you that he needs to see a neuromuscular expert. If you are near Houston, you could see Dr Sheikh. If you are near Dallas, you could see Dr Vernino. Both of these guys are very familiar with autoimmune neuropathies.

      Reply

  2. I am a 52 year old female, who was in an excellent state of health prior to 13 months ago when I had sudden onset of intense burning pain that came out of nowhere as I lay down for bed one night. It started in my upper right back, traveled through the shoulder and down the arm into my right hand. I felt my chest and arm muscles quivering throughout. The pain lasted in my shoulder and arm for about 3 weeks and a course of oral steroids prescribed by my PCP seemed to help kick it out. About a week or so after onset, I noticed weakness of my right arm and inability to raise it above my head. My scapula became noticeably “winged” about 3 weeks after onset. I went to the MD having no idea what happened when they asked me and all I could think was that I did something to my neck in a home yoga practice a few days earlier (I’d been doing this yoga for years…) I never had neck pain per se and always had full range of motion of my neck with no pain.

    I had a cervical MRI and was diagnosed by a physiatrist with cervical spondylosis/radiculopathy. He agreed I may injured my neck doing yoga. I was sent to a neurosurgeon but the idea of an ACDF seemed too risky and extreme. My neurologist did an EMG that he said showed C6 nerve root irritation but the paraspinals were negative. He agreed I should not have surgery and said if I was not better in one year to not despair because the nerve regeneration could take longer. I went to physical therapy and had some return to strength in my right triceps over about 8 months (from 3/5 to 4-/5).

    Several months later when researching “winged scapula” I came across brachial neuritis or Parsonage Turner Syndrome. I was stunned to see that it could be the result of immunization or vaccines and suddenly remembered I had had a flu shot two weeks prior to the onset of my symptoms. In November 2013 I saw my neurologist and asked if this could be my diagnosis. He agreed this diagnosis was a possibility especially due to the paraspinals result on m EMG but said “it is difficult to prove”.

    Currently I have atrophy of the right deltoid, right triceps (this has improved a bit), right scapula winging, and numbness in my hand/fingers, especially the index finger/thumb. My right forearm also has some numbness/weakness. The numbness in the right index finger has been consistent. Occasionally I have pain in my shoulder when I move it the wrong way. I am unable to lean back on my right palm when sitting, due to weakness and pain. I cannot lift my right arm all the way up due to limited range of motion. Several times a day I lift the right arm up with my left to prevent frozen shoulder. I cannot use a computer mouse and can really only tolerate a laptop with frequent breaks.

    I am seeing my neurologist in follow up next week. He suggested if I was not better he would do an MRI of the brachial plexus. I don’t feel I have improved that much and am very concerned for my future as I am right hand dominant.

    Do you have any suggestions for this visit since it appears I may have been misdiagnosed? I feel pretty certain this is secondary to the flu vaccine I received. My very first flu vaccine was in December 2011.

    Reply

    • Rose, Thanks for your post and for sharing your story. I do think it is pretty likely that you had brachial neuritis. A lot of people in your situation actually get unnecessary spine surgery because their C-Spine MRIs come back abnormal, thankfully you did not. You’ll see from the other comments on this page how variable and prolonged recovery from brachial neuritis can be.

      Reply

      • Thank you, Dr. Holland. I may want to get a second opinion in the Boston area….can you recommend a neurologist or is that something done privately? I think I should be having a follow up EMG, the first one in April 2013 did not test my long thoracic nerve as far as I know. I’m not sure what an MRI of the brachial plexus would do other than to help confirm my diagnosis…unless I wanted to undergo some kind of nerve transfer surgery which I don’t. I’m worried about having permanent deficits, however.

      • Rose, I really don’t know any EMGers in Boston personally, but I am sure any neuromuscular physician practicing at one of the Boston teaching hospitals would be great. Let me know how you get on.

      • Hi Rose, I was recently diagnosed with PTS within a week of onset. I am now just past 4 weeks of the onset and have made great progress through PT and steroid infusions. I was under the care of the neurology department at DHMC in Lebanon N.H. I was very impressed with their knowledge of PTS, apparently the see a couple cases a month.

      • Thank you….that is a bit of a drive for me. Maybe I’ll call there and see if they can recommend a specific neurology practice closer to Boston.

        Also, my neurologist wants to do an MRI of the brachial plexus and an MRA of the brachial artery. The study uses gadolinium for contrast, and I’m not psyched about having this injected into my veins. I had a CT with contrast once and later read studies about possible dangers. Wondering if Dr. Holland can comment on doing an MRI of the brachial plexus without contrast. And why do an MRA of the brachial artery? My fingers are pink, seem to have normal circulation…other than the tingling/numbness.

      • Rose, the plexus MRI should be done with contrast (Gad is perfectly safe) and ideally should be an MRN. Not sure why you would need a MRA, unless your doctor suspects a vascular (and not a neurologic) problem.

  3. I have been recently diagnosed with PTS after an excruciating EMG. However I am also having bouts of double vision, dizziness and shortness of breathe. Could these be related?

    Reply

    • Parsonage Turner Syndrome typically causes symptoms confined to the upper limb as described in the post. It can affect the phrenic nerve which leads to paralysis of the diaphragm, and this can lead to shortness of breath. It does not typically cause double vision or vertigo, and these latter symptoms might suggest an alternate diagnosis. Obviously, it is not possible to make a diagnosis in this forum, and if you have not already done so, I would suggest that you see a neurologist for consultation and further evaluation.

      Reply

  4. My 16 year old son tripped and fell while walking in the hallway at school in June 2011 that resulted in a winged scapula. After 18 months of being misdiagnosed (Dr.’s kept going after Spinal Accessory Nerve), he was finally referred to the proper doctor. The proper diagnosis was a compression of the Long Thoracic Nerve confirmed through EMG. He had surgery in Feb. 2013 and the results were wonderful – everything we had hoped for. His rehab went extremely well and moved on to a personal trainer who designed a workout specifically for him. He met with trainer once a week for 6 weeks and workouts got progressively more intense and weights increased quickly.
    About 6 weeks ago he went indoor rock climbing and within hours of this his scapula is winging again and he was in considerable pain. His shoulder is incredibly unstable with some mild tingling in his index, middle and ring finger now.
    He’s been seen by his surgeon who referred us to a specialist and his thoughts are PTS. I’ve been reading everything I can get my hands on since then but have a million questions still. Could rock climbing have been a contributing factor or his workout? How is the diagnosis of PTS confirmed? Waiting on another EMG to be done and working on approval for genetic testing from insurance company.
    We’re confused and overwhelmed, could really use some help!

    Reply

    • Wow, that’s quite a story. The EMG should be the most helpful test, as it will differentiate isolated long thoracic neuropathy from the more widespread abnormalities seen in brachial plexitis. If there is any doubt about this, MR neurography can be very helpful. The genetic testing is probably for HNPP, which can predispose to recurrent brachial plexopathy. It sounds like you’re doing all the right tests, please let us know how things turn out.

      Reply

  5. Dr Holland, I had reaky rare PTS because I had it in both sides, left sholder and right arm. It took 6 months for them to figure out what I had and after 2 sessions of physical theropy i got back 95% in the right arm and 85% in my left sholder. That was over 4 years ago and about 2 weeks ago I joined the YMCA and started a light work out and it seems to aggrivated the left sholder again, is that possible? If so should I stop working out and go back and get more theropy? The pain comes and goes depending on the position of my arm. Example is when driving the pain is the worst when I sit in the seat. Looking forward to your answer.

    Reply

    • Yes, Richard, bilateral brachial neuritis is quite uncommon, and when it occurs it is usually quite asymmetric. Your brachial neuritis occurred so long ago, I doubt that the exercise is causing new inflammation. The shoulder joint is kept in place by the surrounding muscles, the rotator cuff. I suspect your shoulders were left a little destabilized by the residual change in muscle strength, and that the exercises are causing mechanical shoulder pain. I would suggest that you go back to a therapist to get a personalized exercise program that’s right for your situation.

      Reply

  6. Get a Flu Shot ot Not?

    Since it is thought that immunizations might trigger Parsonage Turner Syndrome, is it dangerous for a person diagnosed with PTS to get a flu shot? I had a flu shot last October and the onset of the PTS symptoms began in mid-December. Going without a flu shot guarantees me at least a couple of bouts of respiratory flu during the season. Having a virus is also thought to be a possible trigger for PTS. So maybe it’s a risky gamble either way. Anyone have any advice?

    Reply

    • This a tough question that comes up a lot. In most cases of PTS, I would say go ahead and get the ‘flu shot, the risk of getting sick without the shot is much higher than the risk of recurrent PTS. In your case, since your first episode might actually have been triggered by the ‘flu shot, I might hold off this year.

      Reply

  7. Greetings

    My wife is experiencing pain in her right arm from November 2012. Prior to this she had high fever in the month of Sep-Oct 2012. The pain lasted for few days and gradually subsided (due to having pain killers). This happened almost every alternative months. From august 2013 first week, the pain started developing in neck also and till date it has not subsided. She’s experiencing twitching and pain near the neck and numbness and tingling in her palm and fingers. We took ENMG and MRI scans, visited a lot of Neurosurgeons, everything seemed normal for them. We went to a hand surgeon a week back, after examining her he told us to read about PTS. He said she might be suffering from PTS, just to be confirmed he told us to take uric acid test and vitamin d test. I read about your blog. Is it true she might be suffering from this? If yes, what is the best treatment to cure this completely? We got married this May and I cannot see her suffering everyday. Please help

    Reply

    • So sorry to hear about this. It’s hard to know what’s going on without seeing her. The negative MRI scan makes cervical radiculopathy unlikely. It’s possible she could have a brachial neuritis, RSD, or something else. You’re interests might be best served by seeing a neurologist with expertize in the peripheral nervous system. If you tell me your location and/or nearest big city, I might be able to point you in the right direction.

      Reply

  8. Parsonage Turner Syndrome, or Not?

    I was recently diagnosed with Parsonage Turner Syndrome by an excellent neurosurgeon but one who admits that he is not an expert on PTS. From what I understand about PTS, my case seems to have some inconsistencies. I still wonder if it might be cervical radiculopathy, although there are some aspects of my case that suggest this is not the problem, either. Here are my reasons for questioning my PTS diagnosis:

    1. Sudden onset — PTS seems to always be sudden in onset. However, I seemed to have some precursor symptoms before full on-set in mid-December of 2012. In the summer of 2012, I noticed some pain in my right pectoralis and also between my spine and the right scapula at about C6. This initial pain pretty much went away in both spots. Then in early December it returned and then set in with much more intensity. This time the pain persisted until I had an epidural shot in mid-January.

    2.Pain is not positional in nature — I am reading that PTS pain is not usually affected by body position. My pain was! I could only sleep in certain positions. I had to do my first MRI with my affected arm cocked over my head and that was one of the most painful things I have ever had to go through. For a very long time, I simply could not lie flat on my back with my arms to my side. Even now it’s difficult. The version of the Spurling maneuver when the head is tilted to the affected side and then pushed on from the top does induce some pain.

    3. Brachial Plexus MRI was clear — A second MRI (done in late March 2013)was done of my brachial plexus to see if damage could be seen in the peripheral area. Supposedly the result was that nothing was abnormal. This was reported to me by my neurologist (not the surgeon), and this neurologist leaves very much to be desired. The neurosurgen reasoned that the brachial plexus could still have been affected but that the virus (if that’s what causes PTS) may have passed before the MRI was done — thus showing nothing.

    4. Muscle Pain and Spasming Continues — PTS descriptions usually state that pain comes on rapidly, but then susbsides in a relatively short period of time. Mine never did until an epidural shot in mid-January. I still have pain, however, in my right tricep and in that same spot between my spine and the right scapula. And the triceps muscle continues to twitch and spasm with modest use (like right now as I type this.)

    5. Do All My Affected Muscles Correspond with Typical PTS-affected Muscles? I have not read anything that describes PTS as affecting the pectoralis major muscles. My right pec was the first muscle that went crazy with spasms and twitching. On the other hand, my shoulder itself has remained largely unaffected, as has my right biceps.

    Briefly, the reason that cervical radiculopathy was determined not to be the problem was because my cervical MRIs showed only modest nerve root attenuation at C4, C5 & C6. It would seem that for my triceps and pectoralis to be so affected it would require impingement at C7, which appeared basically clear. In other words, the muscles affected did not correspond to where the nerve root impingements seemed to be most visible — unless I’m “wired up” differently than most people.

    Anyone want to comment? Thanks.

    Reply

    • Thanks for your post Rick. My first comment would be that brachial neuritis is an extremely heterogeneous disorder. Your case has some atypical features. However, you will see from some of the other posts on this site that the pain can be quite chronic and ongoing. Brachial neuritis can affect virtually any muscle. Finally, routine MR imaging is usually normal, and it typically done to rule out other causes of arm pain and weakness like cervical radiculopathy or a compressive lesion. MR neurography (MRN) is more likely to confirm brachial neuritis, but is not widely available nor covered by insurance. See some MRN images here.

      Reply

      • Thanks Dr. Holland for your quick response. MNR looks like a promising technology, but something not available to me. I’m not sure whether my nerve conduction study and EMG revealed anything that might help determine if I really have PTS. My EMG found “acute denervation for the right pronator teres, triceps, and pectoralis muscle and chronic denervation for the supraspinatus muscle….at the level of 6-7″(which is the C-7 nerve root, right?). The EMG report then stated, “This…study is indicative of acute or chronic cervical radiculopathy at level C6-7.” It is clinical determinations like this that make me question the PTS diagnosis. On the other hand, the neurosurgeon stated that the radiologists tend to find and describe what they think the neuro docs are looking for.

        I also have a few interesting potential causal events that ocurred prior to onset in mid-December 2012. In May 2012, I had to breakdown a door in a hostage situation and I did it by barging the door with my shoulders. Afterwards, only my right clavical hurt slightly. Then in June, I pushed a very heavy security gate open to open up traffic in and out of an apartment complex. Afterwards, I felt some pain in my right pectoralis (the afflicted side). It almost felt like muscle tear or strain but it subsided. These two events could perhaps suggest disc damage and thus cervical radiculopathy? Then in July, my new cat bit me on the right forearm and it became infected. I received antibiotics and I believe a tetanus shot. Then he bit me again in October and again I had to take antibiotics for infection. I understand that viruses and or infections are thought to be possible causes of PTS. So maybe it’s all the cat’s fault.

        I can say for sure that sneezing, coughing, or laughing does not increase my pain. Whether they did nearer the time of onset, I can’t remember.

        Rick

  9. Greetings!
    I was diagnosed with Brachial Neuritis in 2010. I have seen over 15 doctors in the Dallas/Plano Texas area. I have been given every differenial diagnosis to include Fibromyagia, RA, MS, Lupus. I had two accidents in 2007, (1) vaccination of Tetanus and Hep and (2) the following month a fall. I was initially diagnosed with Cervical and Lumbar Radiculopathy ….the pain was so bad I prayed to die because I was not brave enough to take my own life. My pain Management doctor said after 4 failed nerve blocks that it was some sort of transient migraine syndrome and referred me to a Psychologist who said I was pain focused and there was no reason for my pain levels of 10 on the scale. the pain in my chest and breathing problems and pressure under my left breast was diagnosed as anxiety and then I was given new dx of anxiety, and chronic pain syndrome . I can not wear my wedding ring because the weight of it sends pain up my arm . my family members cu up my food. I have switched to using smaller drinking glasses because I drop things often. the weakness in my left shoulder and lack of reflexes has everyone stumped as they feel I should be better now. I have been on the side of the road many times because driving too much causes fatigue in my arms and shoulder that I have to be picked up by ambulance and car towed home. I know now from research that the phrenic nerve and diaphram may be involved. I also have uncontrolled blood pressure which was never a problem before 2007. I do have atrophy and areas in left shoulder where i have failed pinprick . I do have winging but not as severe as some of the pictures I have seen.

    After an exhaustive search of this condition I came across the ” AN consult” and I feel so much better knowing that I am not alone and what i am going through is real. Now I know the 8 failed attempts of physical therapy didn’t work for a reason. No matter how passive I could never get past the 3rd repetition of the exercises. Left shoulder surgery and repair of rotator cuff and removal of bone spurs. I have accepted this condition but I will not let it defeat me. Regardless of the reason or cause of this I am now experiencing the same pain in my other arm and shoulder. . I do not believe its overcompensation because the right shoulder is where the initial pain was and then it moved left and now its right again.
    I am female. 46 years old.
    I currently live in San Diego Ca and in need of a referral . I do not want to waste time going to doctors who do not understand BN/NA. Any assistance is greatly appreciated. I am insured and have resource to travel for my care.

    Thank you very much for offering this website for review.

    Reply

    • ms. harris, i’m curious as to the tetnus vaccine you received, was it within a 2-28 day period prior to onset of original symptoms? as I was finally diagnosed with parsonage-turner BN with winging scapula and thoracic outlet syndrome, all symptoms started with in a week to two weeks of receiving the vaccine. and has all been attributed to it. if yours is like mine there is hope for relief, possible long thoracic nerve decompression surgery and possible surgery for the TOS. and if your within a 3yr time frame of date of vaccine to file, there is a federal vaccine adverse reaction compensation program your may want to do some reseach of your own on the matter.

      Reply

      • yes, the symptoms were there but after a bad fall the following month all focus went there! It wasn’t until my pain mgmt doctor told me that with the injections in neck and lower back i should be having improvement…. Physical therapy was making pain and weakness worse . I ultimately had to have shoulder surgery….. I moved on to another few doctors and internet search for help. ( I get your question, I am very familiar with the Vaccine Injury Act and HHS). I could write a book on that experience.

      • I’m very interested in hearing about your experience with HHS as I am there now. Have you ruled out thoracic outlet as your symptoms sound so familiar I have almost constant burning sensations in chest left arm,hand and shoulder just had 3T MRI yesterday at barrows neurological center in Phx hopefully they’ll be able to do something

  10. My husband has had this disease since he was six. In May 2013, he suffered from a stomach virus and with that it caused him to have an episode since then. First, it started with patchy pain all over his upper body. Then the pain started in his legs, which caused him to barely walk. He was admitted into the hospital for a week and put on extreme medicine and pain medicine to help with the pain. Unfortunately, this episode has lasted longer than expected. He is no longer to use his left arm and is not able to sleep at night because the pain gets worse at night. He has also lost a lot of muscles in his body because of this. I have done extensive research about this disease due to nobody in our area knowing nothing about it. Would you happen to know any Centers, Hospitals, Etc. that could help him? If so please contact me, we are looking to give him relief. I know this my be a long shot but we are just looking for help. Thank you!

    Reply

    • Erica, From your description I cannot be sure your husband has Parsonage Turner Syndrome, but he definitely has some kind of neuromuscular problem, if you let me know what part of the county you live in, I can probably direct you to an appropriate expert or center.

      Reply

  11. Comment received by email:

    I realized that my left hand became weaken around 5 years ago. I visited a lot of Drs in my country, but unfortunately, but could not heal it 😦 I try to ignore my problem but It never become better.
    As I am a graduate Student and do love research, sometimes I search about my diseases and look for possible solutions to heal my damn problem. I Suddenly found your website and see you provide some examples of people who has my problem.

    I know I have Brachial neuritis and it involves my left hand from shoulder to the hand kinda( I can send my pics if you want).
    Frankly, Is there any way to heal this kind of problem for sure?
    I really appreciate your answer and help in advance and l am looking forward to receiving your answer.

    Reply

    • Thanks for your email, I posted it as a comment in case others may be interested. It is hard to know the cause of your problem without getting more information. If you could post some pictures and give a description about how the problem started that might help. Otherwise, you should see a neurologist.

      Reply

      • We do not really know when my problem started. It was around six years ago. At that time, I was busy and just focus on my work. Although before that time, everything was ok in my left hand and I did different kind of sports. After 11 months I realized severe weakness in my left hand. During that time, sometimes my left hand started twitching but I thought that is because of stress and life problems. Therefore, I just ignored that!
        After 1 year I suddenly realized my left hand became weaker comparing to the right one. I visited some Drs and neurologist, after doing different experiments, such as EMG, MRI, etc Doctors said it almost affected your top left hand muscles, such as deltoid, brachioradialis, etc. They said the current treatment is physiotherapy along with some vitamins. Due to lack of time, I could not continue to my treatment. I never know the reason of my disease so I always think maybe I can be heal by itself.

    • Thanks for your comment Roger – your make a good point, the course of the disease can be very variable.

      Click here to link to a paper from 2006 which reports a large series of Parsonage-Turner patients. The average duration of pain was 4 weeks, but some patients had pain that persisted much longer.

      Most papers do report an excellent outcome, with full recovery within months to years, but others have reported a more variable outcome.

      Reply

      • My treating doctor at the Cleveland Clinic would disagree. My case is a moderate case in his opinion.

      • If you read the paper the pain described at a 9 on the scale of 1 to 10 is what lasts 1 to 4 weeks. Pain then gradually subsides.

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