Tijdschrift voor geneeskunde vol:64 issue:12 pages:651-653
Painful paresis of both upper limbs two weeks after vaginal delivery.
A 35-year-old female developed severe pain in both shoulders and arms, two weeks after an uncomplicated vaginal delivery. Three days after the onset of the pain, paresis of both upper limbs followed. The clinical diagnosis of neuralgic amyotrophy (Parson-age Turner syndrome) was later on confirmed by magnetic resonance imaging, demonstrating bilateral brachial plexitis, as well as by electrodiagnostic studies.
Neuralgic amyotrophy is a syndrome of presumed immunological origin, which is characterized by the succession of pains, patchy motor dysfunction and atrophy of the arms and shoulders. Sensory symptoms may occur as well. A precipitating event is often partum occurrence. Up to one third of cases are bilateral.
While earlier reports mention an excellent prognosis, recent and larger case series are somewhat less optimistic, observing an incomplete motor recovery or a relapse in a sizable minority.