Neuralgic amyotrophy of Parsonage and Turner. Which nerves are most frequently involved in daily practice? Data from 355 patients.

OBJECTIVES

The aim of this study was to conduct a retrospective analysis of clinical patterns associated with neuralgic amyotrophy of Parsonage and Turner (NAPT) in a series of 355 patients seen in "ambulatory care".

METHODS

Clinical, epidemiological and electrodiagnostic (EDX) data were collected by means of an electrodiagnosis consultation. Data were obtained on age, sex, body mass index, side involved, nerves involved, number of nerves involved per attack, number of attacks per patient, number of bilateral, recurrent, and hereditary cases.

RESULTS

Mean age was 42.7 years, 218 patients (61%) were male, mean body mass index was 23.8; the right side was involved in 232 cases (65%). Inflammatory mononeuropathy (MN) was the most frequent elementary nerve lesion. It was unique (UMN) in 253 patients (71%), and multiple (MMN) in 102 (29%), with a total of 495 neuropathies, and a mean of 2.38 nerves involved in one patient with multiple mononeuropathy (MMN). Five nerves are more frequently involved: long thoracic (n=138), suprascapular (n=129), anterior interosseous (n=53), spinal accessory (SAN) (n=51), lateral antebrachial cutaneous (n=41) nerves. Other nerves (axillary, posterior interosseous, sensory median, phrenic, ulnar and medial antebrachial cutaneous nerves, and lumbo-sacral plexus) are less frequently involved, and less suggestive for NAPT diagnosis. Bilateral, recurrent and hereditary cases were observed in 22, 10 and 0 cases, respectively.

CONCLUSIONS

The clinical patterns of NAPT in ambulatory care thorough an EDX consultation have showed that unique mononeuropathy (UMN) are more frequent than MMN, what results in milder cases; and that five nerves lesions are more frequent and more suggestive of NAPT.