Predisposing factors for incomplete spontaneous recovery after Parsonage-Turner Syndrome

Area of Science:

• Neurology
• Neuroscience
• Orthopedics

Background:

• Parsonage-Turner Syndrome (PTS) is a rare neurological disorder characterized by sudden upper extremity pain, weakness, and muscle atrophy.
• The degree of spontaneous recovery in PTS patients is not fully understood, particularly concerning the influence of antecedent events.

Purpose of the Study:

• To investigate the relationship between antecedent events and the degree of spontaneous recovery in patients with Parsonage-Turner Syndrome.
• To identify demographic and clinical factors associated with spontaneous recovery from PTS.

Main Methods:

• Retrospective review of 100 patients with 144 affected extremities diagnosed with PTS between 2002 and 2021.
• Exclusion of patients with other neurological etiologies and analysis of demographic variables, antecedent events, and recovery outcomes using modified British Medical Research Council (mBMRC) grading.
• Multivariable logistic regression was employed to identify predictors of spontaneous recovery.

Main Results:

• 57.0% of affected extremities showed spontaneous recovery (mBMRC 4-5), while 43.0% had incomplete recovery (mBMRC 0-3).
• Younger age (p=0.02), unilateral involvement (p=0.008), and traumatic antecedent events (OR=27.3, p=0.006) were significantly associated with better spontaneous recovery.
• Increased age, bilateral involvement, and greater muscle involvement were associated with decreased chances of spontaneous recovery.

Conclusions:

• Younger patients with unilateral PTS and less muscle involvement have a higher likelihood of spontaneous recovery.
• Traumatic events preceding PTS may be linked to a better prognosis for spontaneous recovery compared to other triggers.