Parsonage-Turner Syndrome: A Case of Idiopathic Upper Extremity Paresis Following Middle Cranial Fossa Resection of a Vestibular Schwannoma.

OBJECTIVE: In this patient report, Parsonage-Turner syndrome (acute brachial neuropathy) developed in our patient 1 day after resection of a vestibular schwannoma by a middle cranial fossa approach. Aiming to increase awareness of this rare disorder among neurotologists, we describe differential diagnoses, work-up, and management strategies.

PATIENT: A 67-year-old man treated for vestibular schwannoma at a single tertiary referral center.

INTERVENTION: Surgery for vestibular schwannoma, electromyography for confirmation of diagnosis, and physical therapy.

MAIN OUTCOME AND RESULTS: After ruling out postoperative complications by intracranial imaging and physical examination, electromyography was confirmatory of the suspected diagnosis, Parsonage-Turner syndrome; steroids were not indicated. With physical therapy as treatment, our patient is experiencing gradual recovery of all neurologic deficits, including gross motor function.

CONCLUSION: As a rare condition reported only sporadically in the orthopedic and neurology literature, our patient with Parsonage-Turner syndrome represents (to our knowledge) the first within neurotology literature. This rare, idiopathic disease process is usually self-limiting, and may mimic cerebral-vascular accident or injury from surgical positioning. Its presentation is one of limited motor and sensory neuropathies of the brachial plexus distribution.