Parsonage-Turner Syndrome

Authors:
Tyler Drewry, MD, and Hillary Mount, MD
The Christ Hospital/University of Cincinnati Family Medicine Residency Program, Cincinnati, Ohio

Citation:
Drewry T, Mount H. Parsonage-Turner syndrome. Consultant. 2018;58(3):126.

A 29-year-old man presented to the emergency department after having awakened that morning with complete paralysis of his right arm. He was HIV-positive and had a history of attention-deficit/hyperactivity disorder, depression, substance use, and anal carcinoma now in remission. He reported having gone to sleep the previous night with no weakness in his right arm, although he did state that he had slept in an unusual position. Upon awakening, he was unable to move his right arm from the shoulder to the fingertips, and he noticed a painful tingling sensation throughout the arm.

History. The patient stated that he had a normal CD4 lymphocyte count and that his only medications were sertraline and a fixed-dose combination of abacavir, dolutegravir, and lamivudine. He denied any history of recent trauma, recent substance use, stroke, neurologic disorders, chest pain, dyspnea, fever, chills, nausea, vomiting, visual disturbances, syncopal episodes, or loss of bowel or bladder function.

Physical examination. The patient had mild tachycardia to 111 beats/min. He demonstrated flaccid paralysis of the right biceps, triceps, deltoid, and wrist extensors and flexors, retaining only trapezius and levator scapulae function. He had normal radial pulses and normal sensation throughout his right upper extremity, but with decreased biceps and brachioradialis reflexes. He also had crepitus over the right side of his neck and slight tenderness with palpation of the right chest wall.

NEXT: Diagnostic tests

Authors:
Tyler Drewry, MD, and Hillary Mount, MD
The Christ Hospital/University of Cincinnati Family Medicine Residency Program, Cincinnati, Ohio

Citation:
Drewry T, Mount H. Parsonage-Turner syndrome. Consultant. 2018;58(3):126.

A 29-year-old man presented to the emergency department after having awakened that morning with complete paralysis of his right arm. He was HIV-positive and had a history of attention-deficit/hyperactivity disorder, depression, substance use, and anal carcinoma now in remission. He reported having gone to sleep the previous night with no weakness in his right arm, although he did state that he had slept in an unusual position. Upon awakening, he was unable to move his right arm from the shoulder to the fingertips, and he noticed a painful tingling sensation throughout the arm.

History. The patient stated that he had a normal CD4 lymphocyte count and that his only medications were sertraline and a fixed-dose combination of abacavir, dolutegravir, and lamivudine. He denied any history of recent trauma, recent substance use, stroke, neurologic disorders, chest pain, dyspnea, fever, chills, nausea, vomiting, visual disturbances, syncopal episodes, or loss of bowel or bladder function.

Physical examination. The patient had mild tachycardia to 111 beats/min. He demonstrated flaccid paralysis of the right biceps, triceps, deltoid, and wrist extensors and flexors, retaining only trapezius and levator scapulae function. He had normal radial pulses and normal sensation throughout his right upper extremity, but with decreased biceps and brachioradialis reflexes. He also had crepitus over the right side of his neck and slight tenderness with palpation of the right chest wall.

NEXT: Diagnostic tests

Authors:
Tyler Drewry, MD, and Hillary Mount, MD
The Christ Hospital/University of Cincinnati Family Medicine Residency Program, Cincinnati, Ohio

Citation:
Drewry T, Mount H. Parsonage-Turner syndrome. Consultant. 2018;58(3):126.

A 29-year-old man presented to the emergency department after having awakened that morning with complete paralysis of his right arm. He was HIV-positive and had a history of attention-deficit/hyperactivity disorder, depression, substance use, and anal carcinoma now in remission. He reported having gone to sleep the previous night with no weakness in his right arm, although he did state that he had slept in an unusual position. Upon awakening, he was unable to move his right arm from the shoulder to the fingertips, and he noticed a painful tingling sensation throughout the arm.

History. The patient stated that he had a normal CD4 lymphocyte count and that his only medications were sertraline and a fixed-dose combination of abacavir, dolutegravir, and lamivudine. He denied any history of recent trauma, recent substance use, stroke, neurologic disorders, chest pain, dyspnea, fever, chills, nausea, vomiting, visual disturbances, syncopal episodes, or loss of bowel or bladder function.

Physical examination. The patient had mild tachycardia to 111 beats/min. He demonstrated flaccid paralysis of the right biceps, triceps, deltoid, and wrist extensors and flexors, retaining only trapezius and levator scapulae function. He had normal radial pulses and normal sensation throughout his right upper extremity, but with decreased biceps and brachioradialis reflexes. He also had crepitus over the right side of his neck and slight tenderness with palpation of the right chest wall.

NEXT: Diagnostic tests

Authors:
Tyler Drewry, MD, and Hillary Mount, MD
The Christ Hospital/University of Cincinnati Family Medicine Residency Program, Cincinnati, Ohio

Citation:
Drewry T, Mount H. Parsonage-Turner syndrome. Consultant. 2018;58(3):126.

A 29-year-old man presented to the emergency department after having awakened that morning with complete paralysis of his right arm. He was HIV-positive and had a history of attention-deficit/hyperactivity disorder, depression, substance use, and anal carcinoma now in remission. He reported having gone to sleep the previous night with no weakness in his right arm, although he did state that he had slept in an unusual position. Upon awakening, he was unable to move his right arm from the shoulder to the fingertips, and he noticed a painful tingling sensation throughout the arm.

History. The patient stated that he had a normal CD4 lymphocyte count and that his only medications were sertraline and a fixed-dose combination of abacavir, dolutegravir, and lamivudine. He denied any history of recent trauma, recent substance use, stroke, neurologic disorders, chest pain, dyspnea, fever, chills, nausea, vomiting, visual disturbances, syncopal episodes, or loss of bowel or bladder function.

Physical examination. The patient had mild tachycardia to 111 beats/min. He demonstrated flaccid paralysis of the right biceps, triceps, deltoid, and wrist extensors and flexors, retaining only trapezius and levator scapulae function. He had normal radial pulses and normal sensation throughout his right upper extremity, but with decreased biceps and brachioradialis reflexes. He also had crepitus over the right side of his neck and slight tenderness with palpation of the right chest wall.

NEXT: Diagnostic tests