FOR THE TREATMENT
OF PARSONAGE-TURNER SYNDROME:
A CASE STUDY
Lynn W Yang, M.D. and Henry Chang,
is considered by practitioners of Western
medicine to be an alternative method of health
care when other options have been exhausted.
Acupuncture was the only method of relief
for one patient for his left upper extremity
pain, after being appropriately treated with
analgesics and physical therapy for one year.
A case of Parsonage-Tumer Syndrome is further
detailed. Acupuncture treatment was chosen
for relief of all subjective and objective
signs of left arm and shoulder girdle brachial
neuritis. With this knowledge, acupuncture
may be subsequently used as adjuvant therapy
for pain relief in similar patients.
right-handed Caucasian male awoke one morning
in January, 1994, with a left-sided neck and
shoulder girdle spasm causing severe pain,
which was minimally relieved with a muscle
relaxant. The pain radiated from the axilla,
both proximally and distally.
December, 1992, excision
of unstable skin and cross finger flap reconstruction;
left middle and ring fingers were cut off
when he fell on a saw blade. June, 1993, decompression
of the left median and u1nar nerves at the
left wrist, and decompression and anterior
submuscular transposition of the ulnar nerve
at the left elbow.
Employed as a laminator
Lives at home with a supportive wife
one pack of cigarettes per day
any alcohol or recreational drug usage
Lortab (hydrocodone barbiturate and acetominophen),
I tablet 3 times a day as needed for pain
known drug allergies
Magnetic resonance imaging (MRI) of the
C-spine, T-spine, and chest were normal.
Electromyogram (EMG) showed decreased
recruitment of the left long thoracic
Visible and palpable spasm over the left
shoulder girdle, resulting in visible
thoracic scoliosis and left scapular winging.
Unable to forward flex or abduct without
skin discoloration over area of spasms.
of proximal left upper extremity muscles;
distal muscle strength normal.
pin prick, and light touch sensation in
the left upper extremity.
- 27 sessions in 3 years
- 30 gauge, 1.5 inch needles
- Duration of 15 minutes
- No stimulation
- Points: SI 11, BL 60, HT 7
- Ah-Shi points: SI 9, SI 12, LI 11, LI
16, TH 15, GV 20
Outcome / Subjective
- Relief of pain
- Resolution of crampy muscles during movement
Outcome / Objective
- Immediate relief of muscle spasm
- Visible muscle relaxation
- Return of normal skin color
- Resolution of thoracic scoliosis
- Functional range of motion in left upper
The addition of acupuncture
as adjuvant therapy was successful in controlling
the muscle spasm and pain of this syndrome.
The immediate response occurred within 5 minutes,
with resolution of all symptoms. Acupuncture
is an important treatment option for this
disorder, and for severe muscle spasm in general.
FOR ADDITIONAL READING
1. Darby MJ, Wass AR, Fodden DI. Neuralgic
amyotrophy presenting to an accident and emergency
department. Journal of Accident and Emergency
2. Dierckx RA, Ebinger G, Herregodts P, Michotte
A, Carly B, Schmedding E, Maillet B. Recurrent
brachial plexus neuropathy and giant cell
arteritis. Clinical Neurology and Neurosurgery
3. Dyck PJ, Low PA, Stevens JC: Clinical Neurology,
Vol 4., Ch 5 1, J13 Lippincott Company, Philadelphia.
4. Ferrini L, Della Torre P, Perticoni G,
Cantisani TA. Neuralgic amyotrophy of the
shoulder girdle: the Parsonage-Turner Syndrome.
Italian Journal of Orthopaedics and Traurnatology
1986, 12:223-3 1.
5. Magee KR, DeJong RN. Paralytic brachial
neuritis: discussion of clinical features
with review of 23 cases. JAMA 1960,174:10,1258-62.
6. Michotte A, Dierckx R, Deleu D, Herregodts
P, Schmedding E, Bruyland M, Ebinger G. Recurrent
forms of sporadic brachial plexus neuropa-
thy: a report of two cases. Clinical Neurology
and Neurosurgery 1988, 90:1, 71-74.
7. Misamore GW, Lehman DE. Parsonage-Tumer
Syndrome (acute brachial neuritis). Journal
of Bone and Joint Surgery 1996, 78-A:9, 1405-8.
8. Turner JWA, Parsonage MJ. Neuralgic arnyotrophy
(paralytic brachial neuritis). Lancet 1957,27:209-212.
9. Parsonage MJ, Turner JW. Neuralgic amyotrophy:
the shoulder-girdle syndrome. Lancet 1948;1:973-8.
10. Pieters T, Lambert M, Huaux JP, Nagant
DeDeuxchaisnes C. Hemidiaphragmatic paralysis,
an unusual presentation of Parsonage-Turner
Syndrome. Clinical Rheumatology 1988, 7:3,402-5.
11. Spillane JD. Localised neuritis of the
shoulder girdle: a report of 46 cases in the
MEE Lancet 1943,2:532-5.
12. Tsairis P, Dyck PJ, Mulder DW. Natural
history of brachial plexus neuropathy: report
of 99 patients. Archives of Neurology 1972,
13. Vanermen B, Aertgeerts M, Hoogmartens
M, Fabry G. The syndrome of Parsonage and
Turner: discussion of clinical features with
a review of 8 cases. Acta Orthopaedica Belgica
1991. 57:4, 414-9.
Dr. Lynn Yang is a fourth-year Resident in
Physical Medicine and Rehabilitation at Allegheny
University-Graduate Hospital. She completed
her acupuncture training at UCLA College of
Medicine and completed undergraduate work
in biochemistry at Harvard University.
Lynn Yang, M.D.
201 South 18th St., Suite 512
Philadelphia, PA 19103
Dr. Henry Chang is a Board-certified Anesthesiologist.
He has practiced acupuncture for the last
24 years. He is a Diplomat, Academy of Pain
Henry Chang, M.D.
Surgical Anesthesiology Associates, P.A.
Pavillion of Boorhees
2301 Evesharn Road, Suite 401
Boorhees, NJ 08043
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