Parsonage-Turner syndrome, or amyotrophic neuralgia, is characterized by the onset of sudden pain in the shoulder, followed by loss of muscle strength. Cases are confirmed after vaccination against Covid. Symptoms, causes, treatments: answers from Dr Gilles Mondoloni, sports doctor, acupuncturist and osteopath.
[Mise à jour le 8 avril 2022 à 09h28] The National Medicines Agency (ANSM) reported cases of Parsonage-Turner syndrome in its points on the follow-up of side effects of vaccines against covid. Those case are “very rare” but “the role of the vaccine cannot be excluded” she indicated in March 2022. Parsonage-Turner syndrome characterized by a violent pain of sudden onset of the shoulder followed by a arm paralysis is thus part of “signals under surveillance” health authorities regarding vaccines of the Covid (Pfizer, Moderna, AstraZeneca and Janssen).
Definition: what is Parsonage-Turner syndrome?
Parsonage-Turner syndrome, also called “amyotrophic neuralgia”, corresponds to inflammation of the brachial plexusthat is, of a group of nerves, which lies between shoulder and collarbone. This condition mainly affects men around 40. Three phases follow:
- an inflammatory phase causing severe pain in the shoulder,
- decreased muscle strength
- loss of muscle mass.
How many Parsonage-Turner cases linked to Covid vaccination?
Cases of Parsonage-Turner syndrome are reported in France in people who have been vaccinated against Covid. The number is “weak” reassures the ANSM and these cases remain “very rare”. However, “the role of the vaccine cannot be excluded”. Parsonage-Turner syndrome characterized by violent pain of sudden onset of the shoulder followed by a arm paralysis is thus part of “signals under surveillance” health authorities regarding vaccines of the Covid (Pfizer, Moderna, AstraZeneca and Janssen). On March 10, 2022, theANSM brought in a total of 43 severe cases of Parsonage-Turner syndrome since the beginning of the vaccination against Covid with the Pfizer vaccine. 6 first cases serious had been mentioned in the balance sheetAugust 2021. The 43 cases reported were reviewed and analyzed with an expert neurologist and 18 cases were not retained (time to onset too long, too short, etc.). For 25 cases, the diagnosis is well confirmed.
What is the cause of Parsonage-Turner syndrome?
“For a very long time, the cause of Parsonage-Turner syndrome was poorly understood. Today, we think there is a immune origin, that is to say that there is an external factor which promotes the occurrence of this amyotrophic neuralgia of the shoulder in an already weakened subject. The main causes often found are: an infectious factor (viral infection), vaccines which can interfere with the immune system, tattoos showing bacteria or great stress“, reveals Dr. Gilles Mondoloni.
What are the symptoms of Parsonage-Turner syndrome?
Pain is rated 8-9 on a scale of 1 to 10 and will disrupt sleep.
Parsonage-Turner syndrome results in sudden inflammationwhich appears especially at night, and who will lead very strong pain in the shoulder and neck, skin sensitivity, but also strictures and feelings of burning, electric shock. “The pains are evaluated at 8-9 on a scale of 1 to 10 and will disturb sleep. Following this painful phase, which lasts about two weeks, the inflammation calms down a little, and gives way to a decrease in muscle strength in the muscle group corresponding to the affected nerve, i.e. all the muscles around the shoulder: in front, on the sides and behind. Thereafter, there may be muscle wasting : when we press on the muscles of the shoulder, we see that they have melted by dint of not contracting”, specifies the sports doctor and osteopath.
“The diagnosis is not easy to make because these characteristic pains can be confused with tendonitiscalcifications in the shoulder, neuralgia, or even a flare-up of osteoarthritis. It is the occurrence of pain that does not pass after a few days and the onset of loss of muscle strength that make it possible to make the diagnosis“, indicates the specialist.
What are the treatments for Parsonage-Turner syndrome?
Recovery is very long and often requires two to three years to fully recover.
The treatment of Parsonage-Turner syndrome is mainly based on on cortisone administration to calm the inflammation. “It won’t necessarily prevent the process of loss of muscle strength and muscle wasting, but it will calm some of the inflammation in the nerve.“, informs Dr. Gilles Mondoloni. Anti-inflammatories may be prescribed but their effectiveness is less. Powerful analgesics such as codeine, opium, morphine derivatives can be prescribed. “As for the muscular strength which is lacking, rehabilitation work in physiotherapy is necessary to regain muscle strength, and to rework the muscles. Recovery is very long and often requires two to three years to fully recover. Usually, healing leaves no sequelae. Among the alternative medicines, acupuncture and auriculotherapy is effective in reducing pain since it acts on the pain control of these nerves”he concludes.
Thanks to Dr. Gilles Mondoloni, sports doctor, osteopath and acupuncturist (Paris).