Parsonage-Turner Syndrome (Acute Brachial Neuritis)

Parsonage–Turner Syndrome (PTS)—also known as acute brachial neuritis or neuralgic amyotrophy—is a rare neurological condition that affects the brachial plexus, the network of nerves that controls movement and sensation in the shoulder, arm, and hand.

PTS typically appears suddenly, often without a clear injury, and can cause profound pain followed by weakness or muscle loss.

At NYU Langone Health, patients with suspected PTS are evaluated through a coordinated, multidisciplinary approach. Dr. Jacques Hacquebord works closely with our musculoskeletal radiology specialists, nonoperative sports medicine physicians, and neurology partners to ensure accurate diagnosis, targeted treatment, and long-term support throughout recovery.

PTS is an inflammatory condition that affects one or more nerves of the brachial plexus. Unlike neurogenic thoracic outlet syndrome (nTOS), which is caused by anatomical compression, PTS results from inflammation, immune activation, or viral triggers that acutely injure the nerves.

Many patients describe:

• Sudden, severe shoulder or upper arm pain
• Pain that lasts days to weeks
• Followed by muscle weakness, numbness, or loss of function
• Visible muscle wasting (atrophy) in more advanced cases

PTS can involve many different nerves, leading to varied patterns of weakness such as:

• Difficulty lifting the arm (deltoid, supraspinatus weakness)
• Winged shoulder blade (serratus anterior involvement)
• Forearm or hand weakness

PTS may include:

• Sudden onset of intense shoulder or arm pain
• Weakness developing days to weeks later
• Numbness or tingling
• Visible muscle thinning over time
• Difficulty lifting the arm or performing overhead tasks
• Fatigue or reduced endurance of the affected limb

Because symptoms overlap with rotator cuff tears, cervical radiculopathy, and thoracic outlet syndrome, expert evaluation is essential.

Diagnosing PTS can be challenging, which is why our team relies on advanced imaging and coordinated specialist evaluation.

Musculoskeletal Radiology
Our MSK radiology partners play a central role using:

• MR neurography to detect inflammation or swelling of affected nerves
• High-resolution nerve ultrasound to evaluate nerve caliber and structural changes
• Dynamic imaging to differentiate PTS from compressive neuropathies

Electrodiagnostic Testing
EMG and nerve conduction studies help determine:

• Which nerves are affected
• The severity and chronicity of nerve injury
• Whether another diagnosis (such as nTOS or cervical radiculopathy) is present

Sports Medicine & Neurology Collaboration
Nonoperative specialists help guide nonsurgical treatment, monitor recovery, and coordinate therapy.

Most PTS cases improve gradually over months, but recovery can be slow and requires a structured plan.

Non-Operative Management
Treatment typically includes:

• Targeted physical therapy to maintain flexibility and shoulder mechanics
• Strengthening programs as nerve function returns
• Pain management strategies
• Sensory re-education
• Activity modification to reduce strain

Advanced and Surgical Options

While most patients recover without surgery, some may need additional procedures—particularly if there is:

• Persistent weakness
• Severe nerve damage on imaging
• Secondary shoulder problems (e.g., instability or stiffness)

Options may include:

• Nerve transfers
• Tendon transfers
• Procedures to restore shoulder stability or function

Dr. Hacquebord’s upper-extremity reconstruction expertise allows patients access to the full spectrum of surgical options when appropriate.

Recovery from Parsonage–Turner Syndrome can take several months to a few years, depending on which nerves were affected and the severity of inflammation.

With appropriate diagnosis, therapy, and coordinated care, most patients regain substantial function.

Regular follow-up is essential to:

• Monitor muscle recovery
• Adjust therapy protocols
• Identify secondary problems early
• Support return to work, athletics, or daily activities

At the NYU Langone Hand to Shoulder Center, we offer complete care for patients with Parsonage–Turner Syndrome, from initial diagnosis to long-term recovery.

By integrating orthopedic surgery, musculoskeletal radiology, sports medicine, and neurology, we ensure that each patient receives a tailored treatment plan based on the most advanced diagnostic methods available.