Albuminocytologic Dissociation and Intravenous Immunoglobulin Therapy in Parsonage-Turner Syndrome With Bilateral Involvement: A Case Report

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

Parsonage-Turner syndrome (PTS) is a rare neurological disorder characterized by acute neuropathic pain followed motor and sensory deficits, typically affecting the brachial plexus. While often self-limiting, atypical presentations can complicate diagnosis management. We present case of 53-year-old male patient with history cervical foraminal stenosis progressive left upper extremity (LUE) flaccid paralysis for over 14 months, no clear cause worsening symptoms. Diagnostic evaluation, including magnetic resonance imaging (MRI) computed tomography (CT) brain, spine, plexus, revealed grossly normal findings. Initial electromyography (EMG) studies demonstrated response in LUE without typical dermatomal distribution radiculopathy, leading to PTS. Additionally, shoulder subluxation triceps tendon insertional enthesopathy were noted due muscular instability. The was outpatient neurology physical medicine rehabilitation departments when, months later, he developed similar weakness contralateral right (RUE). In clinic, repeat EMG severe axonal denervation or LUE, along new-onset RUE digits, prompting hospital admission. During week-long hospitalization, all blood tests normal, infectious causes ruled out. Notably, cerebrospinal fluid (CSF) analysis albuminocytologic dissociation (ACD), unique finding Given conflicting presence ACD potential an underlying autoimmune inflammatory neuropathy, treated off-label intravenous immunoglobulin (IVIG). IVIG selected corticosteroids chronic nature condition, as there limited clinical evidence supporting steroid efficacy long-term cases. Physical therapy initiated during modest improvement strength. This highlights diagnostic challenges PTS, particularly patients bilateral involvement, progression, A multidisciplinary approach, exclusion other neuromuscular structural pathologies, essential. Early recognition intervention may help mitigate morbidity. Further research into early markers targeted treatments warranted improve outcomes restore function.

Language: Английский

Parsonage-Turner Syndrome: An update

World Journal of Advanced Research and Reviews, Journal Year: 2024, Volume and Issue: 23(1), P. 2882 - 2889

Published: July 30, 2024

Parsonage-Turner Syndrome (PTS), known as Neuralgic Amyotrophy or Brachial Plexus Neuritis, is a rare neurological disorder characterized by sudden onset shoulder pain followed muscle weakness and atrophy. Despite advancements in medical research, the absence of standardized diagnostic treatment protocols poses significant challenges. This review explores multifaceted aspects PTS, including its genetic predispositions, advancements, efficacy, long-term impacts on patients' quality life. The heterogeneity PTS presentations, lack specific biomarkers, unclear etiology contribute to complexities managing this condition. While current treatments vary from conservative aggressive interventions, their efficacy remains inconsistent due syndrome's unpredictable prognosis. disease's social psychological necessitate comprehensive, multidisciplinary approach patient care. underscores need for further research elucidate PTS's immunological underpinnings, develop more accurate tools, establish evidence-based guidelines.

Language: Английский