Neuralgic amyotrophy (Parsonage-Turner syndrome) generally presents with a rather typical pattern of symptoms and signs. 3,4,8,13,14 Acute "neuralgic" pain in the shoulder girdle or arm is almost always the first symptom. Shortly thereafter, focal neurological signs are noticed. Most often, focal muscle weakness and wasting in the shoulder girdle and arm occur, hence the name "neuralgic amyotrophy." Focal sensory loss also occurs, but in most cases it is not marked and may be overlooked by both the patient and physician. The pain, which may be extraordinarily severe for a short time, eventually abates. The focal neurological deficits generally recover over a period of months to years, 13 but in some instances recovery is incomplete. Implicit in the diagnosis of neuralgic amyotrophy is the exclusion of diseases such as focal nerve trauma/compression, vasculitis, neoplasia, or other neuropathic processes that can cause similar clinical findings.
Although the clinical presentation of neuralgic amyotrophy is distinctive in general terms, specific features can be quite variable. [3][4][5][6][7][8][9]14 The diversity of this disease can be striking and is often not appreciated. 3 The commonly recognized syndrome involves muscles around the shoulder girdle and upper arm in the distribution of the long thoracic, suprascapular, axillary, and radial nerves. Because of the prominent involvement of shoulder girdle muscles, some authorities consider this entity a "brachial plexus neuropathy." 13 Indeed, a brachial plexus localization, usually in an upper trunk distribution, does sometimes occur. 3,4 However, detailed clinical and electromyographic examinations of patients often indicate lesions of individual nerves or nerve branches, many of which are not compatible with a brachial plexus localization. [3][4][5][6][7][8][9]14 In fact, Parsonage and Turner 8,14 in their original articles suggested that this disorder in many cases was a form of "mono-