Patients with Neuralgic Amyotrophy Commonly Visit the Emergency Department Without Receiving a Correct Diagnosis.

BACKGROUND

Neuralgic amyotrophy (NA), or Parsonage-Turner syndrome is a peripheral neuropathy characterized by spontaneous, severe pain in the upper extremity, followed by severe muscle weakness.

OBJECTIVE

To determine the frequency with which patients with neuralgic amyotrophy (NA) (Parsonage-Turner syndrome) visit an emergency department (ED) or urgent care center (UCC) at symptom onset, and to characterize their clinical presentations and diagnostic evaluations performed at such visits.

METHODS

This study retrospectively reviewed registries at 2 different sites for patients with suspected NA. Patients were included in this study if their NA diagnoses were confirmed by criteria including clinical signs and symptoms, electrodiagnostic testing (EDX), and imaging (if available). Data was collected through patient surveys and searches of electronic medical records.

RESULTS

From the 2 registries, 178 patients were identified, 30% of whom (54) visited the ED/UCC and 43 met inclusion criteria. During the initial ED/UCC visit, 56% of patients underwent at least 1 of the following imaging examinations: x-ray (37%), MRI (21%), ultrasound (7%) and/or CT (7%). A total of 23% of patients were not provided any specific diagnosis by the ED/UCC and only 1 patient (2%) received a diagnosis of NA. The mean ± standard deviation of the number of days between symptom onset and eventual NA diagnosis was 117 days ± 124.8.

CONCLUSION

Most patients with NA who initially present to an ED/UCC at symptom onset do not receive a correct diagnosis.