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Meredith Meyers
Je'Ne Jordhal
Regan Riddle
Kody Johnson


Neuralgic Amyotrophy, Parsonage Turner Syndrome, Plexus Neuritis


Objective: To describe the successful chiropractic management of a patient with Neuralgic Amyotrophy.

Clinical Features: A 37-year-old male had severe bilateral shoulder pain followed by atrophy and loss of both function and range of motion in the right shoulder girdle, particularly the regions innervated by the C5 nerve root.

Intervention and Outcome: He initially given TramadolTM to help alleviate severe shoulder pain. Following his initial visit, he was treated with a combination of spinal manipulative therapy, vitamin supplementation, therapeutic exercises, and Russian stimulation. He was seen for treatment 34 times over the course of 8 months and regained full range of motion after 6 months as well as a restoration of his normal activities of daily living.

Conclusion: This patient avoided surgery with conservative chiropractic care. The integration of chiropractic manipulation, vitamin supplementation, therapeutic exercises, and Russian stimulation resulted in improvement in range of motion and muscle strength, which were initially lost due to neuralgic amyotrophy.


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1. Parsonage MJ, Turner JW: Neuralgic amyotrophy; the shoulder-girdle syndrome. Lancet 1948;26:973-978

2. van Alfen N, van Eijk JJ, Ennik T et al. Incidence of neuralgic amyotrophy (Parsonage Turner syndrome) in a primary care setting--a prospective cohort study. PLoS One 2015;10(5):e0128361

3. MacDonald BK, Cockerell OC, Sander JW, Shorvon SD. The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain 2000;123:665-676. doi:10.1093/brain/123.4.665

4. Beghi E, Kurland LT, Mulder DW, Nicolosi A. Brachial plexus neuropathy in the population of Rochester, Minnesota, 1970-1981. Ann Neurol 1985;18(3):320-323 doi:10.1002/ana.410180308

5. van Alfen N, van Engelen BG. The clinical spectrum of neuralgic amyotrophy in 246 cases. Brain 2006;129:438-450. doi:10.1093/brain/awh722

6 Tjoumakaris FP, Anakwenze OA, Kancherla V, Pulos N. Neuralgic amyotrophy (Parsonage-Turner syndrome). J Am Acad Orthop Surg 2012;20(7):443-449. doi:10.5435/JAAOS-20-07-443

7 Hannibal MC, Ruzzo EK, Miller LR et al. SEPT9 gene sequencing analysis reveals recurrent mutations in hereditary neuralgic amyotrophy. Neurol 2009;72(20):1755-1759. doi:10.1212/WNL.0b013e3181a609e3

8 van Alfen N. Clinical and pathophysiological concepts of neuralgic amyotrophy. Nat Rev Neurol 2011;7(6):315-322.

9 Kuhlenbäumer G, Meuleman J, De Jonghe P, et al. Hereditary Neuralgic Amyotrophy (HNA) is genetically heterogeneous. J Neurol. 2001;248(10):861-865. doi:10.1007/s004150170070

10 Tsairis P, Dyck PJ, Mulder DW. Natural history of brachial plexus neuropathy. Report on 99 patients. Arch Neurol 1972;27(2):109-117. doi:10.1001/archneur.1972.00490140013004

11 Cruz-Martínez A, Barrio M, Arpa J. Neuralgic amyotrophy: variable expression in 40 patients. J Peripher Nerv Syst 2002;7(3):198-204. doi:10.1046/j.1529-8027.2002.02025.x

12 Tsao BE, Ostrovskiy DA, Wilbourn AJ, Shields RW Jr. Phrenic neuropathy due to neuralgic amyotrophy [published correction appears in Neurol. 2006 Jul 25;67(2):299]. Neurol 2006;66(10):1582-1584. doi:10.1212/01.wnl.0000216140.25497.40

13 Van Eijk JJ, Groothuis JT, Van Alfen N. Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment. Muscle Nerve 2016;53(3):337-350. doi:10.1002/mus.25008

14 Ferrante MA, Wilbourn AJ. Lesion distribution among 281 patients with sporadic neuralgic amyotrophy. Muscle Nerve 2017;55(6):858-861. doi:10.1002/mus.25422

15 van Eijk JJ, van Alfen N, Berrevoets M, van der Wilt GJ, Pillen S, van Engelen BG. Evaluation of prednisolone treatment in the acute phase of neuralgic amyotrophy: an observational study. J Neurol Neurosurg Psych 2009;80(10):1120-1124. doi:10.1136/jnnp.2008.163386

16 Cup EH, Ijspeert J, Janssen RJ, et al. Residual complaints after neuralgic amyotrophy. Arch Phys Med Rehabil 2013;94(1):67-73. doi:10.1016/j.apmr.2012.07.014

17 Ijspeert J, Janssen RM, Murgia A et al. Efficacy of a combined physical and occupational therapy intervention in patients with subacute neuralgic amyotrophy: a pilot study. Neuro Rehabil 2013;33(4):657-665. doi:10.3233/NRE-130993

18 Calderón-Ospina CA, Nava-Mesa MO. B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. CNS Neurosci Ther 2020 Jan;26(1):5-13. doi: 10.1111/cns.13207. Epub 2019 Sep 6. PMID: 31490017; PMCID: PMC6930825.

19 Kurt Oktay, Kubra Neslihan MD; Akpinar et al. The effect of alpha lipoic acid on the recovery of sciatic nerve injury in rats: a prospective randomized controlled trial. Am J Phys Med Rehabil 2021;100: 780-789 doi: 10.1097/PHM.0000000000001642

20. Zhai J, Bo Y, Lu Y, Liu C, Zhang L. Effects of coenzyme Q10 on markers of inflammation: a systematic review and meta-analysis. PLoS One 2017;12(1):e0170172. doi: 10.1371/journal.pone.0170172. PMID: 28125601; PMCID: PMC5268485.

21. Dishman JD, Ball KA, Burke J. First prize: central motor excitability changes after spinal manipulation: a transcranial magnetic stimulation study. J Manipulative Physiol Ther 2002;25(1):1-9