Pediatric Parsonage-Turner Syndrome: A Case Report

초록

CASE REPORT A 7-year-old male presented with a history of fever, headache, and right upper limb muscle pain two weeks ago. Although the pain had improved, he developed weakness in the right upper limb, prompting his visit to the clinic. No trauma history was reported. Brain MRI performed at the time of admission revealed no specific abnormalities, and cerebrospinal fluid (CSF) study yielded normal results. Subsequent Brachial Plexus MRI displayed slight swelling and thickening in the right brachial plexus, with unclear soft tissue changes (Figure 1). To establish a differential diagnosis, Nerve Conduction Studies (NCS) and Electromyography (EMG) were conducted (Table 1). Motor NCS of the right deltoid, biceps, and infraspinatus showed decreased amplitude, while needle EMG in the same muscles revealed denervation potentials and polyphasic motor unit action potentials. No specific abnormal findings were observed in other nerve, sensory NCS, and F-wave tests performed. In accordance with the clinical suspicion of Brachial Neuritis (clinically, Parsonage-Turner Syndrome), The patient received Intravenous Immunoglobulin (IVIG) treatment at a dose of 400mg/kg for the first 5 days of hospitalization. Subsequently, oral prednisolone was initiated at a dosage of 30mg daily, gradually tapered by 5mg every 5 days over the course of one month. Additionally, Electrostimulation Therapy (EST) and conventional physical therapy were administered. After one month, notable muscle strength recovery was observed (Table 2).