Intravenous corticosteroid therapy for bilateral parsonage-turner syndrome: a case report and review of the literature

• Published in: Regional anesthesia and pain medicine Vol. 39; no. 3; pp. 243 - 247
• Main Authors: Smith, Daniel Philip Wiser, Elliott, Jennifer A, Helzberg, James H
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.05.2014
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adult; Brachial Plexus Neuritis - drug therapy; Brachial Plexus Neuritis - pathology; Brachial Plexus Neuritis - physiopathology; Case reports; Genetic disorders; Humans; Injections, Intravenous; Male; Pain; Regional anesthesia
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1097/AAP.0000000000000070

Parsonage-Turner syndrome (PTS) is a distinct clinical disorder characterized by pain, sensory loss, and impaired mobility of the upper extremities and, less commonly, the lower extremities. Manifestations vary from minor to fairly extensive involvement of the brachial and/or lumbosacral plexus. No evidence-based treatment protocol exists, with only anecdotal support of varied palliative efforts. We describe a case of PTS in an otherwise healthy 19-year-old man presenting with severe neuropathic pain in the right upper extremity progressing to include weakness and contralateral extremity involvement. Intravenous corticosteroids were initiated with resolution of the pain after the first day of therapy and improvement in muscular strength throughout his hospitalization. This case supports the use of intravenous corticosteroids in the literature as a treatment option for PTS to ameliorate intractable pain as well as to impede the progression of motor dysfunction.