Parsonage-Turner Syndrome: A Case of Idiopathic Upper Extremity Paresis Following Middle Cranial Fossa Resection of a Vestibular Schwannoma

Otol Neurotol. 2016 Sep;37(8):1195-8. doi: 10.1097/MAO.0000000000001153.

Abstract

Objective: In this patient report, Parsonage-Turner syndrome (acute brachial neuropathy) developed in our patient 1 day after resection of a vestibular schwannoma by a middle cranial fossa approach. Aiming to increase awareness of this rare disorder among neurotologists, we describe differential diagnoses, work-up, and management strategies.

Patient: A 67-year-old man treated for vestibular schwannoma at a single tertiary referral center.

Intervention: Surgery for vestibular schwannoma, electromyography for confirmation of diagnosis, and physical therapy.

Main outcome and results: After ruling out postoperative complications by intracranial imaging and physical examination, electromyography was confirmatory of the suspected diagnosis, Parsonage-Turner syndrome; steroids were not indicated. With physical therapy as treatment, our patient is experiencing gradual recovery of all neurologic deficits, including gross motor function.

Conclusion: As a rare condition reported only sporadically in the orthopedic and neurology literature, our patient with Parsonage-Turner syndrome represents (to our knowledge) the first within neurotology literature. This rare, idiopathic disease process is usually self-limiting, and may mimic cerebral-vascular accident or injury from surgical positioning. Its presentation is one of limited motor and sensory neuropathies of the brachial plexus distribution.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brachial Plexus Neuritis / diagnosis
  • Brachial Plexus Neuritis / etiology*
  • Cranial Fossa, Middle / surgery
  • Diagnosis, Differential
  • Electromyography
  • Humans
  • Male
  • Neuroma, Acoustic / surgery*
  • Neurosurgical Procedures / adverse effects*
  • Paresis / diagnosis
  • Paresis / etiology
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*