Pre-Plexal Extension of Parsonage-Turner Syndrome With Nerve Root Involvement on Needle Electromyography

Area of Science:

• Neurology
• Immunology
• Neuroinflammation

Background:

• Parsonage-Turner syndrome (PTS) is an inflammatory, immune-mediated neurogenic condition causing severe shoulder pain, weakness, and atrophy.
• Typically affecting the brachial plexus, PTS rarely involves nerve roots or paraspinal muscles.
• Cervical radiculopathy and diabetic cervical radiculoplexus neuropathy are key differentials for proximal neuropathic root involvement.

Purpose of the Study:

• To present a rare case of Parsonage-Turner syndrome with cervical paraspinal muscle involvement.
• To highlight a proximal, pre-plexal extension of the idiopathic inflammatory immune process in PTS.
• To contribute to the understanding of PTS pathophysiology and differential diagnoses.

Main Methods:

• Case report presentation.
• Detailed clinical assessment including neurological examination.
• Needle electromyography (EMG) to evaluate muscle involvement.

Main Results:

• The case demonstrated Parsonage-Turner syndrome with significant findings of cervical paraspinal muscle involvement on needle EMG.
• This involvement represents a rare proximal, pre-plexal extension of the inflammatory immune process characteristic of PTS.
• The findings challenge the typical understanding of PTS localization.

Conclusions:

• Parsonage-Turner syndrome can exhibit rare proximal extensions involving cervical paraspinal muscles.
• Needle EMG is crucial for identifying such atypical presentations of PTS.
• This case expands the spectrum of PTS manifestations and aids in differentiating it from other neuropathies.