Butterfield James A, Gunn Kiernan J, Sweitzer Keith, Catanzaro Michael, McHenry Linda, Ketonis Constantinos
University of Rochester Medical Center, NY, USA.
Hand (N Y). 2025 Aug 4:15589447251352003. doi: 10.1177/15589447251352003.
Parsonage-Turner syndrome (PTS) is an uncommon neuropathy classically characterized by acute onset shoulder pain followed by muscle weakness and usually eventual resolution. In the post-COVID-19 era with large portions of the population experiencing viral infection and vaccination, multiple case reports of PTS surfaced in medical literature, with only 1 case report in hand literature.
A systematic review was performed using PubMed, Embase, Scopus, Web of Science, and Google Scholar to identify all reported cases of PTS related to COVID-19 infection or vaccination. Trends in diagnostic modalities and treatment options were recorded.
Thirty-two reports on 54 patients were identified detailing PTS cases following COVID-19 vaccination, and 21 reports on 26 patients following COVID-19 infection. Patients presented an average of 9.5 days following vaccination versus 18.8 days postinfection. Magnetic resonance imaging (MRI) was performed on 82.5% of patients, with the most common findings being normal, hourglass-like constrictions, intramuscular edema on T2-weighted images, and enlargement of regional lymph nodes. Seventy-nine percent (79%) of patients had nerve conductive study (NCS) and electromyography (EMG) performed an average of 6.6 weeks following musculoskeletal symptom onset.
As more patients are routinely vaccinated against and/or contract COVID-19, an increase of these patients presenting to hand clinics is possible. Electrodiagnostic studies and MRI may best be obtained 2 and 3 weeks, respectively, after symptom onset. In addition, repeat EMG/NCX should be obtained 9 to 12 months after symptom onset to assess if surgical interventions are indicated. Hand surgeons should be prepared to diagnose and institute therapies to optimize recovery.
Parsonage-Turner综合征（PTS）是一种罕见的神经病变，其典型特征为急性发作的肩部疼痛，随后出现肌肉无力，通常最终可缓解。在新冠疫情后时代，大量人群经历了病毒感染和疫苗接种，医学文献中出现了多例PTS病例报告，而在手外科文献中仅有1例病例报告。
使用PubMed、Embase、Scopus、Web of Science和谷歌学术进行系统综述，以确定所有与新冠病毒感染或疫苗接种相关的PTS报告病例。记录诊断方式和治疗选择的趋势。
共确定了32篇关于54例患者的报告，详细描述了新冠疫苗接种后发生的PTS病例，以及21篇关于26例患者新冠病毒感染后的报告。患者在接种疫苗后平均9.5天出现症状，而在感染后平均18.8天出现症状。82.5%的患者进行了磁共振成像（MRI）检查，最常见的结果为正常、沙漏样狭窄、T2加权图像上的肌肉内水肿以及局部淋巴结肿大。79%的患者在肌肉骨骼症状出现后平均6.6周进行了神经传导研究（NCS）和肌电图（EMG）检查。
随着越来越多的患者常规接种新冠疫苗和/或感染新冠病毒，可能会有更多此类患者前往手外科诊所就诊。症状出现后2周和3周分别进行电诊断检查和MRI检查可能最为合适。此外，应在症状出现后9至12个月重复进行EMG/NCX检查，以评估是否需要进行手术干预。手外科医生应做好诊断和制定治疗方案的准备，以优化恢复效果。
