Lakkireddy Maheshwar, Sathu Sreedhar, Kumar Ravi, Madhu Latha Karra, Maley Deepak Kumar
Orthopaedics, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
Orthopaedics and Trauma, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
Cureus. 2022 Aug 10;14(8):e27867. doi: 10.7759/cureus.27867. eCollection 2022 Aug.
Parsonage-Turner Syndrome (PTS) is a rare neurological disorder involving brachial plexus and periscapular muscles following viral infection, surgery, and vaccination. We hereby describe the first case of PTS from India following Covishield (AstraZeneca ChAdOx1 nCoV-19) COVID-19 vaccination. A 21-year-old healthy male presented to us with complaints of pain and weakness in the right shoulder five weeks after Covishield vaccination on the contralateral deltoid. There was no history of injury or constitutional symptoms. On examination, hyperalgesia over the area innervated by the axillary nerve and wasting of the deltoid, supra, and infraspinatus muscles were noted. An MRI scan of the shoulder, cervical spine, and brachial plexus neurogram were normal. Decreased motor amplitude in right axillary and musculocutaneous nerve was recorded in the nerve conduction study (NCS). High titers of SARS-COV-2 IgG neutralizing antibodies were noted after a single dose of vaccination and SARS CoV-2 IgM antibodies were negative. Having been diagnosed with post-vaccination PTS, the right shoulder was splinted and an intravenous injection of 1g methylprednisolone was administered for three days followed by oral steroids for three weeks. NCS and electromyography at 10 weeks showed insignificant differences between the two sides suggesting early neurological recovery. Currently, the patient is being followed up regularly for complete neurological recovery. PTS is a known side effect of vaccination. We report the index case of PTS following the administration of Covishield vaccination from India to aid in early diagnosis and management, further evaluation, and public health safety.
Parsonage-Turner综合征（PTS）是一种罕见的神经系统疾病，在病毒感染、手术和接种疫苗后累及臂丛神经和肩胛周围肌肉。我们在此描述印度首例接种Covishield（阿斯利康ChAdOx1 nCoV-19）新冠疫苗后发生的PTS病例。一名21岁健康男性在对侧三角肌接种Covishield疫苗五周后，因右肩疼痛和无力前来就诊。无受伤史或全身症状。检查时，发现腋神经支配区域有痛觉过敏，三角肌、冈上肌和冈下肌萎缩。肩部、颈椎的MRI扫描及臂丛神经造影均正常。神经传导研究（NCS）显示右腋神经和肌皮神经运动幅度降低。单剂疫苗接种后检测到高滴度的SARS-CoV-2 IgG中和抗体，SARS-CoV-2 IgM抗体为阴性。确诊为接种疫苗后PTS后，对右肩进行了夹板固定，并静脉注射1g甲泼尼龙，持续三天，随后口服类固醇药物三周。10周时的NCS和肌电图显示两侧差异不显著，提示神经功能早期恢复。目前，正在对该患者进行定期随访，以观察神经功能是否完全恢复。PTS是一种已知的疫苗接种副作用。我们报告了印度接种Covishield疫苗后发生PTS的首例病例，以协助早期诊断和管理、进一步评估以及公共卫生安全。
