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Case Reports
. 2022 Mar 16;22(1):96.
doi: 10.1186/s12883-022-02622-4.

COVID-19 atypical Parsonage-Turner syndrome: a case report

Maria Beatrice Zazzara  1 , Anna Modoni  2 , Alessandra Bizzarro  3 , Alessandra Lauria  3 , Francesca Ciciarello  3 , Cristina Pais  3 , Vincenzo Galluzzo  3 , Francesco Landi  3 , Matteo Tostato  3 ; Gemelli Against COVID-19 Post-Acute Care Team
Collaborators, Affiliations
Case Reports

COVID-19 atypical Parsonage-Turner syndrome: a case report

Maria Beatrice Zazzara et al. BMC Neurol. .

Abstract

Background: Neurological manifestations of Sars-CoV-2 infection have been described since March 2020 and include both central and peripheral nervous system manifestations. Neurological symptoms, such as headache or persistent loss of smell and taste, have also been documented in COVID-19 long-haulers. Moreover, long lasting fatigue, mild cognitive impairment and sleep disorders appear to be frequent long term neurological manifestations after hospitalization due to COVID-19. Less is known in relation to peripheral nerve injury related to Sars-CoV-2 infection.

Case presentation: We report the case of a 47-year-old female presenting with a unilateral chest pain radiating to the left arm lasting for more than two months after recovery from Sars-CoV-2 infection. After referral to our post-acute outpatient service for COVID-19 long haulers, she was diagnosed with a unilateral, atypical, pure sensory brachial plexus neuritis potentially related to COVID-19, which occurred during the acute phase of a mild Sars-CoV-2 infection and persisted for months after resolution of the infection.

Conclusions: We presented a case of atypical Parsonage-Turner syndrome potentially triggered by Sars-CoV-2 infection, with symptoms and repercussion lasting after viral clearance. A direct involvement of the virus remains uncertain, and the physiopathology is unclear. The treatment of COVID-19 and its long-term consequences represents a relatively new challenge for clinicians and health care providers. A multidisciplinary approach to following-up COVID-19 survivors is strongly advised.

Keywords: Atypical brachial plexus neuritis; COVID-19 neurological manifestations; COVID-19 neuromuscular sequelae; Sars-CoV-2 infection.

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Conflict of interest statement

None of the participants in the Gemelli Against COVID-19 Post-Acute Care Study Group and none of the authors has any conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
Presentation of patient’s neuropathic symptoms as captured by the neurological physical examination. In light grey: T1 dermatome. In dark grey: T2 dermatome. In blue: areas characterized by dysesthesia. In red: areas characterized by both dysesthesia and mild hypoesthesia. Image was hand produced and graphically elaborated by Lorenzo Di Stefano on behalf of all authors
Fig. 2
Fig. 2
(A-B): DWI coronal scan showing segmental DWI-restriction of the left upper trunk (proximal–distal extension:6 cm) (A), confirmed at ADC-map (B)
Fig. 3
Fig. 3
(A-B-C): T2-weighted short-tau inversion recovery (STIR) MRI sequences showing corresponding hyperintensity and thickening of the left upper trunk
Fig. 4
Fig. 4
(a-b): T2 STIR coronal scan showing some confluent lymph nodes with irregular borders in left supraclavicular fossa
See this image and copyright information in PMC

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