Abstract Details

Title Post-Operative Parsonage Turner Syndrome: A Ghost of Christmas Past?

Topic Peripheral Nerve

Presentation(s) P01 - (-)

Poster/Presentation
Number 134

Objective

Background BACKGROUND: PTS is a neuropathy of the brachial plexus which occurs in two forms: hereditary and idiopathic. Although the etiology of most forms remains idiopathic, the most plausible theories implicate an immune-mediated reaction.

Design/Methods DESIGN/METHODS: Two cases are reported in which PTS was observed post operatively.

Results RESULTS: Case 1: A 36 year old man reported pain followed by numbness and weakness in the left upper extremity after clavicle malunion surgery. He was found to have a brachial neuritis on EMG. Case 2: A 54 year old woman presented with pain in the left shoulder and arm followed by weakness of left digit 2 and thumb flexion following a right total hip replacement and was found to have a left anterior interosseous neuropathy on examination and EMG and was diagnosed with Parsonage Turner syndrome.

Conclusions CONCLUSIONS: PTS can be a difficult syndrome to diagnose. The exact cause is unknown but many factors are thought to influence its development, including trauma, infection, viral disease, heavy exercise, immunization, and autoimmune conditions. We believe that post-operative patients are at risk for developing brachial neuritis. Only two other post-operative PTS caes have been described in the literature but we suspect that many more exist but are not acknowledged due to lack of recognition of this phenomenon. Literature suggests that the stres of surgery may activate an unidentified virus lying dormant in nerve roots. These cases are additional evidence that surgery can serve as a precipitating event that activates the immune process that is implicated in Parsonage Turner syndrome.

Authors/Disclosures
Teena Shetty, MD, FAAN (Hospital for Special Surgery) PRESENTER	Dr. Shetty has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for mTBI, Inc. The institution of Dr. Shetty has received research support from Marker AG. The institution of Dr. Shetty has received research support from GE-NFL.
	No disclosure on file
	No disclosure on file
Steven Levine, MD, FAHA (SUNY Downstate Medical Center)	Dr. Levine has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MEDLINK. Dr. Levine has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Law Firms. The institution of Dr. Levine has received research support from NIH.

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