Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States Marine
Neuralgic amyotrophy (NA) also known as Parsonage–Turner syndrome is an inflammatory disorder of the brachial plexus characterized by sudden, acute onset of severe pain of the arm and/or shoulder followed by muscle weakness and sensory abnormalities. Although management may involve physical therapy,...
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Wiley
2021-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2021/6663755 |
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| author | Carissa M. Sedlacek Michael Leone Adam D. Foster Amy Hinkelman |
| author_facet | Carissa M. Sedlacek Michael Leone Adam D. Foster Amy Hinkelman |
| author_sort | Carissa M. Sedlacek |
| collection | DOAJ |
| description | Neuralgic amyotrophy (NA) also known as Parsonage–Turner syndrome is an inflammatory disorder of the brachial plexus characterized by sudden, acute onset of severe pain of the arm and/or shoulder followed by muscle weakness and sensory abnormalities. Although management may involve physical therapy, immunomodulatory drugs, and analgesics, there is nothing specific for the treatment of NA. Full functional recovery can take months to years, but recurrence and/or persistence of symptoms and disability are frequent. This case reports a 22-year-old male who recovered from NA within 3 months following treatment with 1000 mg of methylprednisolone and off-label use of 0.5 g/kg of intravenous immunoglobulins (IVIG) for four consecutive days. Three years later, the patient experienced soreness and paresthesia of the shoulder following a military shooting exercise, and 0.75 g/kg of IVIG and 1000 mg of MP were prescribed for 2 consecutive days resulting in complete recovery and no recurrences to date. EMG findings, 3.5-year postinitial treatment, revealed improvement in the brachial plexopathy. This provides support for the combined use of IVIG and glucocorticoids in the treatment of NA and highlights the need for further studies investigating whether this combined treatment regimen may accelerate recovery and improve long-term outcomes for patients diagnosed with NA. |
| format | Article |
| id | doaj-art-b73c5f57f4fa4f7eac5f94168f1b6de5 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
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| series | Case Reports in Medicine |
| spelling | doaj-art-b73c5f57f4fa4f7eac5f94168f1b6de52025-02-03T05:44:12ZengWileyCase Reports in Medicine1687-96271687-96352021-01-01202110.1155/2021/66637556663755Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States MarineCarissa M. Sedlacek0Michael Leone1Adam D. Foster2Amy Hinkelman3Campbell University, Jerry M. Wallace School of Osteopathic Medicine, P.O. Box, Buies Creek, NC 27506, USANeurology Department, Gundersen Health System, 1900 South Avenue, La Crosse, WI 54601, USADepartment of Anatomy, Campbell University, Jerry M. Wallace School of Osteopathic Medicine, P.O. Box 4280, Buies Creek, NC 27506, USADepartment of Microbiology and Immunology, Campbell University, Jerry M. Wallace School of Osteopathic Medicine, P.O. Box 4280, Buies Creek, NC 27506, USANeuralgic amyotrophy (NA) also known as Parsonage–Turner syndrome is an inflammatory disorder of the brachial plexus characterized by sudden, acute onset of severe pain of the arm and/or shoulder followed by muscle weakness and sensory abnormalities. Although management may involve physical therapy, immunomodulatory drugs, and analgesics, there is nothing specific for the treatment of NA. Full functional recovery can take months to years, but recurrence and/or persistence of symptoms and disability are frequent. This case reports a 22-year-old male who recovered from NA within 3 months following treatment with 1000 mg of methylprednisolone and off-label use of 0.5 g/kg of intravenous immunoglobulins (IVIG) for four consecutive days. Three years later, the patient experienced soreness and paresthesia of the shoulder following a military shooting exercise, and 0.75 g/kg of IVIG and 1000 mg of MP were prescribed for 2 consecutive days resulting in complete recovery and no recurrences to date. EMG findings, 3.5-year postinitial treatment, revealed improvement in the brachial plexopathy. This provides support for the combined use of IVIG and glucocorticoids in the treatment of NA and highlights the need for further studies investigating whether this combined treatment regimen may accelerate recovery and improve long-term outcomes for patients diagnosed with NA.http://dx.doi.org/10.1155/2021/6663755 |
| spellingShingle | Carissa M. Sedlacek Michael Leone Adam D. Foster Amy Hinkelman Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States Marine Case Reports in Medicine |
| title | Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States Marine |
| title_full | Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States Marine |
| title_fullStr | Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States Marine |
| title_full_unstemmed | Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States Marine |
| title_short | Off-Label Use of Intravenous Immunoglobulin with Methylprednisolone to Treat Parsonage–Turner Syndrome in a United States Marine |
| title_sort | off label use of intravenous immunoglobulin with methylprednisolone to treat parsonage turner syndrome in a united states marine |
| url | http://dx.doi.org/10.1155/2021/6663755 |
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