Unraveling the mysteries of parsonage turner syndrome: A journey towards optimal management. A systematic review.

Autor: Al Hinai R; School of Medicine, University College Dublin, Dublin, Ireland.; St Vincent's University Hospital, Department of Plastic and Reconstructive Surgery, Dublin, Ireland., Kelly L; Royal College of Surgeons in Ireland, Dublin, Ireland., O'Connor M; Royal College of Surgeons in Ireland, Dublin, Ireland., Berman H; Royal College of Surgeons in Ireland, Dublin, Ireland., Abdul Jalil L; St Vincent's University Hospital, Department of Plastic and Reconstructive Surgery, Dublin, Ireland., Sowa A; School of Medicine, University College Dublin, Dublin, Ireland., McDonnell JM; Royal College of Surgeons in Ireland, Dublin, Ireland.; National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland., Dolan R; Royal College of Surgeons in Ireland, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Journal of hand and microsurgery [J Hand Microsurg] 2024 Aug 09; Vol. 16 (5), pp. 100142. Date of Electronic Publication: 2024 Aug 09 (Print Publication: 2024).
DOI: 10.1016/j.jham.2024.100142
Abstrakt: Aims: Parsonage Turner Syndrome (PTS) is a peripheral neuropathy manifesting as sudden onset pain, muscle weakness, and atrophy. This review aims to analyse long-term outcomes reported in adult patients with PTS, and establish an optimised management approach.
Methods: A comprehensive literature search was performed using MEDLINE, PubMed, and the Cochrane Library. Articles that met the eligibility criteria were included. Analysis on time to presentation, presentation, interventions and long-term functional outcomes was conducted. All relevant information was collected by two independent reviewers.
Results: Twenty-five studies, comprising 950 PTS patients, were identified. Patients averaged 43.8 years in age, with a F:M ratio of 0.6:1, and presented symptoms spanning 1-24 months prior to seeking medical attention. Management details were elucidated for 402 patients (42 ​%), with 87 ​% managed conservatively. Among conservatively managed patients, over 50 ​% exhibited no improvement. 62/402 (15 ​%) necessitated surgical interventions, including neurolysis, decompression, nerve transfers, and diaphragmatic plication. 25/31 (80.6 ​%) neurolysis cases demonstrated full functional recovery, including pain resolution and full muscle strength, between 1 day and 13 months (average 2.9 months). 2 nerve transfer cases achieved full forward flexion at 2.5 months. Overall, long-term outcomes of PTS, reported at 5-25 months, revealed residual neuropathic pain in 60 ​% and incomplete motor function return in 70 ​% of patients.
Conclusions: PTS recognition and referral challenges persist, impeding timely management. While surgical interventions are advocated after three months for incomplete recovery, long-term surgical outcomes are inadequately reported. An optimal surgical strategy for stagnant nerve recovery needs to be devised for this challenging cohort of patients.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2024 Society for Indian Hand Surgery and Micro Surgeons. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
Databáze: MEDLINE
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