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Diagnosis
Peripheral Nerve and Plexus
Plexus and Peripheral Nerve Lesions
Idiopathic Brachial Plexus Neuritis
Idiopathic Brachial Plexus Neuritis
Kevin R. Moore, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Neuralgic amyotrophy idiopathic neuritis involving upper brachial plexus (idiopathic brachial plexus neuritis), cervical plexus, lumbosacral plexus ± cranial nerves
                • Synonym: Parsonage-Turner syndrome
                  • Subset of neuralgic amyotrophy
                • Acute brachial neuritis

              • Definitions

                • Immune-mediated neuropathy of brachial plexus

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Patel RH et al: Post-operative emergence of acute brachial neuritis following posterior cervical laminectomy with fusion: a case report and review of the literature. Int J Surg Case Rep. 65:197-200, 2019
                                          2. Su PH et al: A CARE-compliant article: a case report of idiopathic brachial neuritis treated with ultrasound-guided electroacupuncture. Medicine (Baltimore). 98(19):e15325, 2019
                                          3. van Alfen N et al: Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy. Neurology. 91(9):e843-9, 2018
                                          4. McEnery T et al: Phrenic nerve palsy secondary to Parsonage-Turner syndrome: a diagnosis commonly overlooked. Lung. 195(2):173-7, 2017
                                          5. Seror P: Neuralgic amyotrophy. An update. Joint Bone Spine. 84(2):153-8, 2017
                                          6. Yuh EL et al: Diffusivity measurements differentiate benign from malignant lesions in patients with peripheral neuropathy or plexopathy. AJNR Am J Neuroradiol. 36(1):202-9, 2015
                                          7. Fransz DP et al: Parsonage-Turner syndrome following post-exposure prophylaxis. BMC Musculoskelet Disord. 15:265, 2014
                                          8. Gupta A et al: Neuralgic amyotrophy (Parsonage Turner syndrome). Orthopedics. 37(2):75, 130-33, 2014
                                          9. Nociti V et al: Case of postpartum Parsonage-Turner syndrome. Muscle Nerve. 49(2):294-5, 2014
                                          10. Park MS et al: Magnetic resonance neurographic findings in classic idiopathic neuralgic amyotrophy in subacute stage: a report of four cases. Ann Rehabil Med. 38(2):286-91, 2014
                                          11. Smith CC et al: Challenging pain syndromes: Parsonage-Turner syndrome. Phys Med Rehabil Clin N Am. 25(2):265-77, 2014
                                          12. Smith DP et al: Intravenous corticosteroid therapy for bilateral parsonage-turner syndrome: a case report and review of the literature. Reg Anesth Pain Med. 39(3):243-7, 2014
                                          13. Kumar I et al: Utility of magnetic resonance imaging in the diagnosis of unsuspected cases of Parsonage-Turner syndrome: two case reports. J Med Case Rep. 7:255, 2013
                                          14. Gazioglu S et al: Magnetic resonance imaging in bilateral brachial neuritis with pure sensory involvement. Neurol Sci. 33(4):927-30, 2012
                                          15. Tjoumakaris FP et al: Neuralgic amyotrophy (Parsonage-Turner syndrome). J Am Acad Orthop Surg. 20(7):443-9, 2012
                                          16. Zara G et al: MR imaging of peripheral nervous system involvement: Parsonage-Turner syndrome. J Neurol Sci. 315(1-2):170-1, 2012
                                          17. Yamada K et al: MRI findings and steroid therapy for neuralgic amyotrophy in children. Pediatr Neurol. 45(3):200-2, 2011
                                          18. Sureka J et al: MRI of brachial plexopathies. Clin Radiol. 64(2):208-18, 2009
                                          19. Safran MR: Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve. Am J Sports Med. 32(3):803-19, 2004
                                          20. Safran MR: Nerve injury about the shoulder in athletes, part 2: long thoracic nerve, spinal accessory nerve, burners/stingers, thoracic outlet syndrome. Am J Sports Med. 32(4):1063-76, 2004
                                          21. Gourie-Devi M et al: Long-term follow-up of 44 patients with brachial monomelic amyotrophy. Acta Neurol Scand. 107(3):215-20, 2003
                                          22. Janes SE et al: Brachial neuritis following infection with Epstein-Barr virus. Eur J Paediatr Neurol. 7(6):413-5, 2003
                                          23. Carroll KW et al: Magnetic resonance imaging of the shoulder: a review of potential sources of diagnostic errors. Skeletal Radiol. 31(7):373-83, 2002
                                          24. Cruz-Martinez A et al: Neuralgic amyotrophy: variable expression in 40 patients. J Peripher Nerv Syst. 7(3):198-204, 2002
                                          25. Gonzalez-Alegre P et al: Idiopathic brachial neuritis. Iowa Orthop J. 22:81-5, 2002
                                          26. Antoniou J et al: Suprascapular neuropathy. Variability in the diagnosis, treatment, and outcome. Clin Orthop. (386):131-8, 2001
                                          27. Simon JP et al: Parsonage-Turner syndrome after total-hip arthroplasty. J Arthroplasty. 16(4):518-20, 2001
                                          28. Watson BV et al: Isolated brachialis wasting: an unusual presentation of neuralgic amyotrophy. Muscle Nerve. 24(12):1699-702, 2001
                                          29. Miller JD et al: Acute brachial plexus neuritis: an uncommon cause of shoulder pain. Am Fam Physician. 62(9):2067-72, 2000
                                          30. Bredella MA et al: Denervation syndromes of the shoulder girdle: MR imaging with electrophysiologic correlation. Skeletal Radiol. 28(10):567-72, 1999
                                          31. Helms CA et al: Acute brachial neuritis (Parsonage-Turner syndrome): MR imaging appearance--report of three cases. Radiology. 207(1):255-9, 1998
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Neuralgic amyotrophy idiopathic neuritis involving upper brachial plexus (idiopathic brachial plexus neuritis), cervical plexus, lumbosacral plexus ± cranial nerves
                                                        • Synonym: Parsonage-Turner syndrome
                                                          • Subset of neuralgic amyotrophy
                                                        • Acute brachial neuritis

                                                      • Definitions

                                                        • Immune-mediated neuropathy of brachial plexus

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Patel RH et al: Post-operative emergence of acute brachial neuritis following posterior cervical laminectomy with fusion: a case report and review of the literature. Int J Surg Case Rep. 65:197-200, 2019
                                                                                  2. Su PH et al: A CARE-compliant article: a case report of idiopathic brachial neuritis treated with ultrasound-guided electroacupuncture. Medicine (Baltimore). 98(19):e15325, 2019
                                                                                  3. van Alfen N et al: Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy. Neurology. 91(9):e843-9, 2018
                                                                                  4. McEnery T et al: Phrenic nerve palsy secondary to Parsonage-Turner syndrome: a diagnosis commonly overlooked. Lung. 195(2):173-7, 2017
                                                                                  5. Seror P: Neuralgic amyotrophy. An update. Joint Bone Spine. 84(2):153-8, 2017
                                                                                  6. Yuh EL et al: Diffusivity measurements differentiate benign from malignant lesions in patients with peripheral neuropathy or plexopathy. AJNR Am J Neuroradiol. 36(1):202-9, 2015
                                                                                  7. Fransz DP et al: Parsonage-Turner syndrome following post-exposure prophylaxis. BMC Musculoskelet Disord. 15:265, 2014
                                                                                  8. Gupta A et al: Neuralgic amyotrophy (Parsonage Turner syndrome). Orthopedics. 37(2):75, 130-33, 2014
                                                                                  9. Nociti V et al: Case of postpartum Parsonage-Turner syndrome. Muscle Nerve. 49(2):294-5, 2014
                                                                                  10. Park MS et al: Magnetic resonance neurographic findings in classic idiopathic neuralgic amyotrophy in subacute stage: a report of four cases. Ann Rehabil Med. 38(2):286-91, 2014
                                                                                  11. Smith CC et al: Challenging pain syndromes: Parsonage-Turner syndrome. Phys Med Rehabil Clin N Am. 25(2):265-77, 2014
                                                                                  12. Smith DP et al: Intravenous corticosteroid therapy for bilateral parsonage-turner syndrome: a case report and review of the literature. Reg Anesth Pain Med. 39(3):243-7, 2014
                                                                                  13. Kumar I et al: Utility of magnetic resonance imaging in the diagnosis of unsuspected cases of Parsonage-Turner syndrome: two case reports. J Med Case Rep. 7:255, 2013
                                                                                  14. Gazioglu S et al: Magnetic resonance imaging in bilateral brachial neuritis with pure sensory involvement. Neurol Sci. 33(4):927-30, 2012
                                                                                  15. Tjoumakaris FP et al: Neuralgic amyotrophy (Parsonage-Turner syndrome). J Am Acad Orthop Surg. 20(7):443-9, 2012
                                                                                  16. Zara G et al: MR imaging of peripheral nervous system involvement: Parsonage-Turner syndrome. J Neurol Sci. 315(1-2):170-1, 2012
                                                                                  17. Yamada K et al: MRI findings and steroid therapy for neuralgic amyotrophy in children. Pediatr Neurol. 45(3):200-2, 2011
                                                                                  18. Sureka J et al: MRI of brachial plexopathies. Clin Radiol. 64(2):208-18, 2009
                                                                                  19. Safran MR: Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve. Am J Sports Med. 32(3):803-19, 2004
                                                                                  20. Safran MR: Nerve injury about the shoulder in athletes, part 2: long thoracic nerve, spinal accessory nerve, burners/stingers, thoracic outlet syndrome. Am J Sports Med. 32(4):1063-76, 2004
                                                                                  21. Gourie-Devi M et al: Long-term follow-up of 44 patients with brachial monomelic amyotrophy. Acta Neurol Scand. 107(3):215-20, 2003
                                                                                  22. Janes SE et al: Brachial neuritis following infection with Epstein-Barr virus. Eur J Paediatr Neurol. 7(6):413-5, 2003
                                                                                  23. Carroll KW et al: Magnetic resonance imaging of the shoulder: a review of potential sources of diagnostic errors. Skeletal Radiol. 31(7):373-83, 2002
                                                                                  24. Cruz-Martinez A et al: Neuralgic amyotrophy: variable expression in 40 patients. J Peripher Nerv Syst. 7(3):198-204, 2002
                                                                                  25. Gonzalez-Alegre P et al: Idiopathic brachial neuritis. Iowa Orthop J. 22:81-5, 2002
                                                                                  26. Antoniou J et al: Suprascapular neuropathy. Variability in the diagnosis, treatment, and outcome. Clin Orthop. (386):131-8, 2001
                                                                                  27. Simon JP et al: Parsonage-Turner syndrome after total-hip arthroplasty. J Arthroplasty. 16(4):518-20, 2001
                                                                                  28. Watson BV et al: Isolated brachialis wasting: an unusual presentation of neuralgic amyotrophy. Muscle Nerve. 24(12):1699-702, 2001
                                                                                  29. Miller JD et al: Acute brachial plexus neuritis: an uncommon cause of shoulder pain. Am Fam Physician. 62(9):2067-72, 2000
                                                                                  30. Bredella MA et al: Denervation syndromes of the shoulder girdle: MR imaging with electrophysiologic correlation. Skeletal Radiol. 28(10):567-72, 1999
                                                                                  31. Helms CA et al: Acute brachial neuritis (Parsonage-Turner syndrome): MR imaging appearance--report of three cases. Radiology. 207(1):255-9, 1998