Parsonage–Turner syndrome

The neuralgic Schulteramyotrophie (actually Schultermyatrophie, through the English language is also the name Parsonage -Turner syndrome usual) is a neurological disease of unknown cause. It is commonly known as inflammation of the Armnervengeflechts ( brachial plexus ) interpreted by immune complexes. The majority of the right arm is concerned, both sides may impair health.

Symptoms

First symptom is a violent, tearing pain in the shoulder and upper arm area, lasts for a few days. As a result, there would quickly be often pronounced paralysis of the shoulder and upper arm muscles. Particularly affected is the deltoid muscle, besides also the musculi supraspinatus, infraspinatus, serratus anterior and trapezius, sometimes the biceps or the diaphragm. Movements such as abduction or lifting the arm are substantially restricted or impossible. Fast is also an atrophy of denervated muscles visible. Sensory disturbances are usually not very pronounced and may be absent. A typical image is also a protruding shoulder blade (scapula alata ) in certain movements.

Diagnosis

What counts is the study findings: it is always the coverage areas of multiple spinal nerve roots and several peripheral nerves affected. The electromyography of the deltoid, the signs of denervation show. The measurement of the nerve results in pathological values ​​, in extreme cases, no signal is detected. An examination of the cerebrospinal fluid often does not continue, but may be useful for the exclusion of differential diagnoses. Basically a blood test is done to rule out a viral infection. In addition, a magnetic resonance imaging of the cervical vertebrae and the plexus is useful to exclude as a herniated disc or other visible causes.

Treatment and prognosis

No specific therapy does not exist. Painkillers can be used symptomatically. The administration of corticosteroids is controversial. It is important in severe paralysis of the shoulder to avoid stiffening by capsule shrinkage by being passively moved. If the rotator cuff is paralyzed, the shoulder joint dislocation or subluxation can tend to and should be fixed in a federation.

The likelihood of a full recovery depends on the healing process of the first few months. If no improvement, paralysis likely to remain in the future. Add 3/4 of the cases, but the disease heals completely within two years. It is important active support from physiotherapy and targeted controlled movements with low pollution. Since there is a paralysis, movements must be re- learned. In this way, the prognosis for a force structure of the arms is up to the complete restoration of performance quite well.