Parsonage-Turner syndrome after COVID-19 infection

Parsonage-Turner syndrome, affecting suprascapular nerve and especially to infraspinatus muscles after COVID-19 vaccination in a professional wrestler, a case report and literature review of causes and treatments

BACKGROUND

Acute peripheral neuropathy, also known as Parsonage-Turner syndrome or neuralgic amyotrophy, mostly affects the upper brachial plexus trunks, which include the shoulder girdle. It is typically accompanied by abrupt, intense pain, weakness, and sensory disruption. The etiology and causes of this disease are still unknown because of its low prevalence, however viral reactions-induced inflammation is one of its frequent causes.

CASE PRESENTATION

Here, we introduce a professional wrestler patient who was diagnosed with PTS after vaccination and was treated, and we review some articles in this field.

CONCLUSION

When it comes to shoulder-girdle complaints and pain, Parsonage-Turner syndrome can be a differential diagnosis. Corticosteroids during the acute period, followed by physical therapy, appear to be an efficient way to manage pain, inflammation, muscular atrophy, and the process of recovering to full nerve regeneration.

Parsonage-Turner Syndrome and SARS-CoV-2 Infection: A Literature Review With Case Presentation

Neuralgic amyotrophy, also known as Parsonage-Turner syndrome (PTS), is characterized by severe pain and muscle wasting affecting the anterior body, including the head, shoulder, upper limb, and chest wall. Often triggered by an antecedent event, such as infection, PTS encompasses various conditions historically identified as separate entities. In 1948, Parsonage and Turner unified these conditions under the term neuralgic amyotrophy based on shared features of intense pain and muscular atrophy. Recent studies have highlighted PTS as a spectrum disorder with diverse manifestations, including pure sensory neuropathy, extensive neuropathy, spinal accessory nerve involvement, and diaphragmatic palsy. We reviewed 26 documented cases of PTS following SARS-CoV-2 infection, emphasizing the importance of considering PTS in individuals with a history of COVID-19 due to varied clinical presentations. Standardized diagnostic methods and comprehensive evaluations are crucial for accurate diagnosis and management. Future research should focus on consistent evaluation methods and employing a comprehensive differential diagnosis approach.

Parsonage-Turner Syndrome following COVID-19 infection: A Report of Three Cases

Introduction

Parsonage-Turner Syndrome (PTS), previously referred to as neuralgic amyotrophy or idiopathic brachial plexopathy, is a rare neurological syndrome characterized by an abrupt onset of shoulder pain followed by neurological deficits of motor weakness, numbness, and muscular atrophy. Although the pathophysiology and specific cause of PTS remain unclear, it has been reported following trauma, vaccination, surgical procedures and viral infection. Our practice has seen an increase in the incidence of PTS with the COVID-19 pandemic. We aim to describe three cases of patients found to have PTS shortly after proven infection with COVID-19 during the Omicron surge.

Case Description

Three patients developed symptoms of PTS within a few weeks of having COVID-19. All three cases had normal imaging and an EMG that diagnosed PTS. The first is a 23-year-old male who developed weakness and shoulder pain two weeks after his COVID-19 diagnosis. The second was a 58-year-old male who was intubated with COVID-19 pneumonia and woke up with extreme weakness and pain in his left arm. The final case was a 76-year-old male with a remote history of a left total shoulder arthroplasty who also developed acute pain and weakness soon after testing positive for COVID-19. All three patient's symptoms and clinical exam have been improving.

Discussion

In this report, we presented three patients who developed PTS soon after being diagnosed with COVID-19 during the omnicron surge. As we learn more about the COVID-19 virus and its effects on the musculoskeletal system, efficient diagnosis and multidisciplinary treatment of Parsonage-Turner Syndrome will become increasingly valuable to physicians and patients.

Associations and Disease–Disease Interactions of COVID-19 with Congenital and Genetic Disorders: A Comprehensive Review

Since December 2019, the COVID-19 pandemic, which originated in Wuhan, China, has resulted in over six million deaths worldwide. Millions of people who survived this SARS-CoV-2 infection show a number of post-COVID complications. Although, the comorbid conditions and post-COVID complexities are to some extent well reviewed and known, the impact of COVID-19 on pre-existing congenital anomalies and genetic diseases are only documented in isolated case reports and case series, so far. In the present review, we analyzed the PubMed indexed literature published between December 2019 and January 2022 to understand this relationship from various points of view, such as susceptibility, severity and heritability. Based on our knowledge, this is the first comprehensive review on COVID-19 and its associations with various congenital anomalies and genetic diseases. According to reported studies, some congenital disorders present high-risk for developing severe COVID-19 since these disorders already include some comorbidities related to the structure and function of the respiratory and cardiovascular systems, leading to severe pneumonia. Other congenital disorders rather cause psychological burdens to patients and are not considered high-risk for the development of severe COVID-19 infection.