Association of Parsonage–Turner syndrome with COVID-19 infection and vaccination: a systematic review

Abstract

Objectives The exact etiology of Parsonage–Turner syndrome is unknown, but it is known to be preceded by infection, vaccination, or surgical intervention. In this review, we describe associations of Parsonage–Turner syndrome with COVID-19 infection and vaccination. Methods A systematic literature search was conducted using PubMed/MEDLINE, ScienceDirect, and Google Scholar. Microsoft Excel was used for data extraction and statistical analysis. The quality of case reports and case series was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Results We selected 44 case reports and 10 case series, including 68 patients (32 post-vaccination and 36 with post-COVID-19 infection Parsonage–Turner syndrome). Middle-aged males were predominantly affected in both groups. The most frequently administered vaccine was Comirnaty (Pfizer) (53%). The mean latency was 11.7 days in the post-vaccination group and 20.3 days in the post-infection group. The most affected nerves in both groups were the axillary, suprascapular, and musculocutaneous nerves; and 78.1% and 38.9% of patients showed partial amelioration of their symptoms in the post-vaccination and post-infection groups, respectively. Conclusion Post-vaccination Parsonage–Turner syndrome presents earlier than post-infection disease. Pain and sensorimotor deficits of the upper limb are common in both situations. Complete or partial recovery occurs in most cases.

The Utility of an Epidural Steroid Injection for the Treatment of Idiopathic Brachial Neuritis

“…Interestingly, there has recently been a significant number of reported cases of brachial neuritis following both COVID-19 vaccination and COVID-19 infection, further suggesting an autoimmune precedent [7][8][9][10][11][12][13]. One systematic review analyzed 68 patients, 32 post-vaccination and 34 post-infection with COVID-19, who experienced brachial neuritis following vaccination or infection [7]. Another recent report noted 42 specific cases reported following vaccination [12].…”

The Impact of COVID-19 on the Guillain–Barré Syndrome Incidence

“…The case study concerned a female who was old, while in the country, the total number of cases was only 82 [ 40 ]. COVID-19 has been linked to a less-known Parsonage–Turner syndrome, usually manifested by sudden severe shoulder pain followed by motor weakness [ 41 ] or with an appearance later neuromuscular disorders [ 42 ]. In addition, myasthenia gravis can be included in the neuromuscular junction disorders that occurred in three patients without previous neurological or autoimmune disorders [ 43 ].…”

Multimodal Rehabilitation Management of a Misunderstood Parsonage–Turner Syndrome: A Case Report during the COVID-19 Pandemic

“…A recent systematic review analyzed 26 reported cases of PTS following the administration of the SARS-CoV-2 vaccine [ 2 ]. Another systematic review suggested an association not only with COVID-19 infection but also after vaccination, with an earlier onset of PTS symptoms post-vaccination compared to the infection itself [ 4 ]. It typically affects adult males more frequently with a sudden onset [ 5 ], and sometimes atypical manifestations can occur, such as lower limb and diaphragmatic deficits [ 6 ].…”