Incidence of neuralgic amyotrophy (Parsonage Turner syndrome) in a primary care setting--a prospective cohort study

Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting....

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Bibliographic Details
Published in:PloS one 2015-05, Vol.10 (5), p.e0128361-e0128361
Main Authors: van Alfen, Nens, van Eijk, Jeroen J J, Ennik, Tessa, Flynn, Sean O, Nobacht, Inge E G, Groothuis, Jan T, Pillen, Sigrid, van de Laar, Floris A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Brachial Plexus Neuritis - diagnosis
Brachial Plexus Neuritis - epidemiology
Care and treatment
Child
Child, Preschool
Codes
Cohort analysis
Complications
Diagnosis
Diagnostic systems
Evaluation
Female
Genetic disorders
Genetics
Health care
Hospitals
Humans
Immunoglobulins
Incidence
Infant
Infant, Newborn
Male
Medical diagnosis
Methods
Middle Aged
Muscular atrophy
Neck
Nervous system
Neurologic Examination - methods
Neurology
Neurosciences
Patients
Peripheral nervous system
Peripheral Nervous System Diseases - diagnosis
Peripheral Nervous System Diseases - epidemiology
Primary care
Primary care nursing
Primary Health Care - methods
Prospective Studies
Shoulder
Turner's syndrome
Vigilance
Young Adult
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Summary:Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting. In a prospective cohort study during the year 2012 we registered all new cases of neck, shoulder or arm complaints from two large primary care centers serving a population of 14,118. Prior to study, general practitioners received a short training on how to diagnose classic neuralgic amyotrophy. Neuralgic amyotrophy was defined according to published criteria irrespective of family history. Only patients with a classic phenotype were counted as definite cases. After inclusion, patients with suspected neuralgic amyotrophy who had not yet seen a neurologist were offered neurologic evaluation for diagnostic confirmation. Of the 492 patients identified with new onset neck, shoulder or arm complaints, 34 were suspected of having neuralgic amyotrophy. After neurologic evaluation the diagnosis was confirmed in 14 patients. This amounts to a one-year incidence rate for classic neuralgic amyotrophy of 1 per 1000. Our findings suggest that neuralgic amyotrophy is 30-50 times more common than previously thought. Unawareness of the disorder and its clinical presentation seems the most likely explanation for this difference. An incidence rate of 1 per 1000 and the long-term sequelae many patients suffer warrant more vigilance in diagnosing the disorder, to pave the way for timely treatment and prevent complications.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0128361