II. Epidemiology

  1. Incidence: 1.64 per 100,000 (rare)
  2. Age: 30 to 70 years old

III. Etiology

  1. Post-Viral (reported in 25% of cases)
  2. Allergic Reaction
  3. Post-Trauma
    1. Postoperative
    2. Pitching
    3. Backpacker palsy
      1. Hikers or military carrying a heavy backpack for hours
      2. Results in compression and traction at the Brachial Plexus

IV. Symptoms

  1. Shoulder weakness follows pain within 1 to 30 days
  2. Hand Paresthesias may be present
  3. Acute severe Shoulder Pain or arm and Neck Pain for 1-2 weeks
    1. Sharp, intense pain
    2. Worse at night
    3. Pain of short duration

V. Signs

  1. Scapular Winging
  2. Weakness occurs in multiple ShoulderMuscle groups
    1. Deltoid Muscle
    2. Rotator cuff Muscles
    3. Biceps Muscle
    4. Triceps Muscle
  3. Non-dermatomal sensory loss typically develops
    1. Especially lateral antebrachial cutaneous (radial aspect of Forearm)

VI. Diagnostics

  1. Electromyogram shows neurogenic atrophy

VII. Differential Diagnosis

  1. Cervical Radiculopathy
    1. Dermatomal Distribution of deficits (non-dermatomal in Acute Brachial Neuritis)
    2. Spurling's Test typically positive (negative in Acute Brachial Neuritis)
  2. Rotator Cuff Syndrome
  3. Extremity Trauma
  4. Acute Shoulder Arthritis
  5. Adhesive Capsulitis

VIII. Management

  1. Symptomatic care
  2. Corticosteroids may be considered (but not consistently supported by literature)

IX. Prognosis

  1. Full recovery in 89% by 2-3 years
  2. Recurrence in up to 25%

X. References

  1. Delaney, Orman, Herbert in Herbert (2016) EM:Rap 16(12): 3-4
  2. Simon (2023) Am Fam Physician 107(5): 503-12 [PubMed]

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Related Studies

Ontology: Brachial Plexus Neuritis (C0221759)

Definition (NCI) An inflammatory process affecting the brachial plexus. It results in severe pain in the upper extremity and shoulder, upper arm weakness and loss of sensation in the upper arm.
Definition (MSH) A syndrome associated with inflammation of the BRACHIAL PLEXUS. Clinical features include severe pain in the shoulder region which may be accompanied by MUSCLE WEAKNESS and loss of sensation in the upper extremity. This condition may be associated with VIRUS DISEASES; IMMUNIZATION; SURGERY; heroin use (see HEROIN DEPENDENCE); and other conditions. The term brachial neuralgia generally refers to pain associated with brachial plexus injury. (From Adams et al., Principles of Neurology, 6th ed, pp1355-6)
Concepts Disease or Syndrome (T047)
MSH D020968
ICD10 G54.5
SnomedCT 3548001, 268079007, 156642003, 26609002, 72893007
English Neuropathies, Shoulder-Girdle, Neuropathy, Shoulder-Girdle, Parsonage Turner Syndrome, Parsonage-Turner Syndrome, Shoulder-Girdle Neuropathies, Shoulder-Girdle Neuropathy, Syndrome, Parsonage-Turner, Syndrome, Parsonage-Aldren-Turner, Brachial Plexus Neuritis, brachial neuritis (diagnosis), neuritis brachial, brachial neuritis, Parsonage Aldren Turner Syndrome, Parsonage-Aldren-Turner Syndrome, Brachial Neuritides, Brachial Neuritis, Neuritides, Brachial, Neuritis, Brachial, Brachial Plexus Neuritides, Neuritides, Brachial Plexus, Neuritis, Brachial Plexus, Brachial Plexus Neuritis [Disease/Finding], brachial neuritis plexus, parsonage turner syndrome, neuritis brachial nos, brachial plexus neuritis, shoulder girdle syndrome, amyotrophic neuralgia, shoulder-girdle syndrome, parsonage syndrome turners, neuralgic amyotrophy, parsonage-turner syndrome, parsonage-aldren-turner syndrome, Shoulder-girdle syndrome, Brachial plexus neuritis, Girdle Neuropathies, Shoulder, Shoulder Girdle Neuropathy, Shoulder Girdle Neuropathies, Girdle Neuropathy, Shoulder, Neuropathy, Shoulder Girdle, Neuropathies, Shoulder Girdle, Neuritis - brachial, Shoulder girdle syndrome, Parsonage-Turner syndrome, Parsonage-Aldren-Turner syndrome, Brachial neuritis, Brachial neuritis (disorder), Parsonage-Aldren-Turner, Brachial neuritis, NOS
Dutch brachiale neuritis, schoudergordelsyndroom, brachiale plexus neuritis, Neuritis van de plexus brachialis, Neuritis, plexus-brachialis-, Parsonage-Turner-syndroom, Plexus-brachialisneuritis, Schoudergordelneuropathie
French Névrite brachiale, Syndrome épaule-ceinture scapulaire, Amyotrophie névralgique de l'épaule, Amyotrophie névralgique du membre supérieur, Névrite du plexus brachial de Parsonage-Turner, Névrite du plexus brachial, Syndrome de Parsonage-Turner
German Brachial-Neuritis, Schulter-Guertel-Syndrom, Brachial-Plexus-Neuritis, Parsonage-Turner-Syndrom, Schulter-Arm-Syndrom, Neuritis, Plexus brachialis, Plexus-brachialis-Neuritis
Italian Amiotrofia nevralgica, Sindrome di Parsonage-Turner, Neurite brachiale, Neurite del plesso brachiale
Portuguese Nevrite braquial, Síndrome da cintura escapular, Neurite do plexo braquial, Neurite do Plexo Braquial, Neuropatia da Cintura Escapular, Síndrome de Parsonage-Turner
Spanish Neuritis braquial, Síndrome del hombro, Neuritis del plexo braquial, neuritis braquial (trastorno), neuritis braquial, síndrome de Parsonage - Aldren - Turner, síndrome de la cintura escapular, Neuritis del Plexo Braquial, Neuropatía de la Cintura Escapular, Síndrome de Parsonage-Turner
Japanese 腕神経炎, パーソネージ・ターナー症候群, ウデシンケイエン, ケンコウタイショウコウグン, パーソネージターナーショウコウグン, 筋萎縮-神経痛性, 肩甲帯ニューロパシー, 神経炎-腕神経叢, 上腕神経痛, 肩甲帯症候群, 頸腕神経痛, 肩甲帯神経障害, 肩帯ニューロパシー, パーソニッジ-ターナー症候群, 神経痛性筋萎縮, 筋萎縮症-神経痛性, 肩帯神経障害, 上肢帯ニューロパシー, パーソニッジ・ターナー症候群, 頚腕神経痛, 肩帯症候群, 神経痛性筋萎縮症, 腕神経痛, Parsonage-Turner症候群, 腕神経叢炎, ワンシンケイソウエン
Swedish Brakialplexusneurit
Czech Parsonageův-Turnerův syndrom, plexus brachialis - neuritida, neuropatie ramenního pletence, Syndrom ramenního pletence, Brachiální neuritida, Parsonage-Turnerův syndrom, Neuritida brachiálního plexu
Finnish Hartiapunoksen neuriitti
Russian PARSONEIDZHA-TERNERA SINDROM, AMIOTROFIIA NEVRALGICHESKAIA, NEVRALGIIA AMIOTROFICHESKAIA, TSERVIKO-BRAKHIAL'NAIA NEVRALGIIA, PLECHEVOGO SPLETENIIA NEVRIT, NEVRIT PLECHEVOGO SPLETENIIA, АМИОТРОФИЯ НЕВРАЛГИЧЕСКАЯ, НЕВРАЛГИЯ АМИОТРОФИЧЕСКАЯ, НЕВРИТ ПЛЕЧЕВОГО СПЛЕТЕНИЯ, ПАРСОНЕЙДЖА-ТЕРНЕРА СИНДРОМ, ПЛЕЧЕВОГО СПЛЕТЕНИЯ НЕВРИТ, ЦЕРВИКО-БРАХИАЛЬНАЯ НЕВРАЛГИЯ
Croatian BRAHIJALNI PLEKSUS, NEURITIS
Polish Zapalenie nerwu splotu ramiennego
Hungarian Brachialis neuritis, Vállöv syndroma, Parsonage-Turner-syndroma, Plexus brachialis neuritis
Norwegian Parsonage-Turners syndrom, Plexus brachialis-nevritt, Brakialnevritt

Ontology: Brachial radiculitis (C0392447)

Concepts Disease or Syndrome (T047)
SnomedCT 202765006, 268079007, 156642003, 267977009, 27830001
Italian Radicolite brachiale
Japanese 上腕の神経根炎, ジョウワンノシンケイコンエン
Czech Radikulitida brachiální
English Radiculitis brachial, brachial neuritis radiculitis, brachial radiculitis, cervical brachial neuritis, radiculitis brachial, Brachial (cervical) neuritis, Brachial radiculitis, Brachial (cervical) neuritis (disorder), Brachial radiculitis (disorder), brachial; radiculitis, radiculitis; brachial, Brachial radiculitis, NOS
Hungarian Brachialis radiculitis
Dutch brachialis; radiculitis, radiculitis; brachialis, radiculitis brachiaal
Spanish neuritis braquial (cervical) (trastorno), neuritis braquial (cervical), radiculitis braquial (trastorno), radiculitis braquial, Radiculitis braquial
Portuguese Radiculite braquial
French Radiculite brachiale
German Brachial-Radikulitis

Ontology: Neuralgic Amyotrophy (C1510479)

Concepts Disease or Syndrome (T047)
MSH D020968
ICD9 353.5
ICD10 G54.5
SnomedCT 3548001, 193113006, 26609002
English Amyotrophies, Neuralgic, Neuralgic Amyotrophies, Amyotrophy, Neuralgic, Neuralgic Amyotrophy, neuralgic amyotrophy, neuralgic amyotrophy (diagnosis), Amyotrophic Neuralgias, Neuralgias, Amyotrophic, Amyotrophic Neuralgia, Neuralgic amyotrophy, Neuralgic amyotrophy (disorder), neuralgic; amyotrophy, amyotrophy; neuralgic, Neuralgia, Amyotrophic
Italian Amiotrofia nevralgica
Japanese 神経痛性筋萎縮症, シンケイツウセイキンイシュクショウ
Czech amyotrofická neuralgie, neuralgická amyotrofie, Neuralgická amyotrofie
Portuguese Neuralgia Amiotrófica, Amiotrofia neurálgica, Amiotrofia Neurálgica
Spanish Neuralgia Amiotrófica, amiotrofia neurálgica (trastorno), amiotrofia neurálgica, Amiotrofia neurálgica, Amiotrofia Neurálgica
French Névralgie amyotrophique, Amyotrophie névralgique
German Neuralgie, amyotrophe, neuralgische Schulteramyotrophie, Neuralgische Amyotrophie, Amyotrophie, neuralgische
Korean 신경통성 근위축
Hungarian Neuralgiás amyotrophia
Norwegian Amyotrofisk nevralgi
Dutch amyotrofie; neuralgisch, neuralgisch; amyotrofie, neuralgische amyotrofie, Amyotrofie, neuralgische, Neuralgie, amyotrofische, Neuralgische amyotrofie