Parsonage-Turner syndrome: a long-term follow-up study of 42-cases in Guangxi, China

Parsonage-Turner syndrome (PTS) is a rare peripheral neuropathy with variable clinical manifestations. Its true incidence is higher than previously recognized, characterized by a prolonged recovery period, potential residual disability and limb pain, which poses a persistent challenge for clinic.

Forty-seven patients with PTS were admitted to our hospital's hand surgery center between November 2017 and November 2022, 42 of whom were included in the retrospective study, with the exception of 5 patients whose data were incomplete. Demographic information, clinical data, and auxiliary examination results were collected, and all patients were regularly followed up. Outcomes were evaluated via the Medical Research Council (MRC) muscle strength grading scale and visual analogue scale (VAS) pain score. SPSS 22.0 software was used for statistical analysis.

The annual incidence of PTS was 47 per 100,000 individuals. The 42 patients, 27 males and 15 females, had an average age of 41.1 ± 20.3 years. The average period between onset and diagnosis was 60 days, and the right or dominant limb was more commonly affected. The most frequent initial symptom was spontaneous pain (69%), with the majority of cases affecting the shoulder girdle (72%). The suprascapular nerve (52%), long thoracic nerve (50%), and axillary nerve (38%) were the most frequently affected nerves. Seven individuals underwent surgery because of failure to respond or poor recovery after at least 3 months of nonsurgical treatment. The average follow-up time was 54.8 ± 15.0 months. Most patients achieved effective recovery within two years, with 18 attaining complete recovery and 13 achieving partial recovery (MRC Grade 4). Twenty-one patients experienced chronic pain.

The frequency of PTS in hand surgery center is relatively high, and the epidemiological patterns are similar to those reported in previous studies. However, the majority of patients experience untimely treatment, which results in residual pain and inadequate motor function recovery. Enhancing clinical awareness of PTS for early diagnosis should be prioritized, particularly in cases of suprascapular nerve dysfunction combined with long thoracic nerve dysfunction or isolated posterior interosseous nerve dysfunction following spontaneous pain.