Turner Syndrome of the Parsonage: Description and Underlying Factors
Article: Understanding Parsonage-Turner Syndrome (PTS)
Parsonage-Turner Syndrome (PTS) is a rare neurological condition that primarily affects the shoulder and arm, causing symptoms such as muscle weakness, unusual sensations on the skin, and in some cases, complete paralysis.
The condition is often triggered by various factors, including viral illnesses, immunizations, surgeries, strenuous exercise, autoimmune diseases, and certain genetic predispositions.
Viral infections, notably COVID-19, can precede PTS onset by triggering immune responses against nerves. Immunizations and surgeries may also act as antigenic triggers, provoking nerve inflammation. Physical strain or strenuous exercise can precipitate episodes of PTS, likely through mechanical stress or immune activation. Autoimmune diseases such as systemic lupus erythematosus (SLE), temporal arteritis, and polyarteritis nodosa may also contribute to PTS, although these associations are less commonly reported.
Genetic factors, such as mutations in the SEPTIN9 gene, may increase susceptibility or worsen clinical outcomes with exposure to external triggers.
PTS is thought to be triggered primarily by an immune-mediated inflammatory process rather than direct nerve infection. Autoimmune microvasculature inflammation may also contribute to nerve damage.
Diagnosing PTS involves a physical examination, a medical history, and tests and imaging scans. Imaging tests can help rule out other conditions and confirm a diagnosis of PTS. A medical professional may request tests such as an MRI scan or an X-ray. The doctor may also order an electromyography (EMG) test to record the electrical activity of the muscle and show whether the muscle is responding to the nerves and whether the nerves are causing muscle weakness.
The prognosis for PTS depends on the severity of the condition and the cause. Most people regain their original strength and function within 2 years, but it may take more than 2 years for some individuals to regain their original strength, and they may still experience chronic pain and residual symptoms and complications.
Individuals whose condition does not respond well to medication or physiotherapy may require surgery. Surgical procedures to treat PTS include nerve grafting and tendon transfer surgery. These involve taking either healthy nerve tissue or a tendon and using it to restore or replace damaged tissue.
Treatment for PTS may also include medications for pain or inflammation, corticosteroid medications and nonsteroidal anti-inflammatory drugs. A doctor may also prescribe specific drugs to treat nerve pain, such as gabapentin, carbamazepine, or amitriptyline. Some individuals may need physiotherapy and rehabilitation to regain functional use of their shoulders. Such therapies may include kinesiotherapy, transcutaneous electrical nerve stimulation, deep dermal therapy, cryotherapy, or functional electric stimulation.
PTS is a complex condition that requires careful diagnosis and treatment. If you or someone you know is experiencing symptoms of PTS, it is essential to seek medical advice promptly.
- The prognosis for Parsonage-Turner Syndrome (PTS) often depends on the cause, with most people regaining their original strength and function within 2 years through physical therapy and medications for pain or inflammation.
- With PTS, individuals who do not respond well to medications or physiotherapy may require surgery, such as nerve grafting or tendon transfer surgery, to restore or replace damaged tissue, as part of their treatment plan in health and wellness.
