Top

Published in:

01-12-2022 | Turner's Syndrome | Case report

COVID-19 atypical Parsonage-Turner syndrome: a case report

Authors: Maria Beatrice Zazzara, Anna Modoni, Alessandra Bizzarro, Alessandra Lauria, Francesca Ciciarello, Cristina Pais, Vincenzo Galluzzo, Francesco Landi, Matteo Tostato, Gemelli Against COVID-19 Post-Acute Care Team

Published in: BMC Neurology | Issue 1/2022

Abstract

Background

Neurological manifestations of Sars-CoV-2 infection have been described since March 2020 and include both central and peripheral nervous system manifestations. Neurological symptoms, such as headache or persistent loss of smell and taste, have also been documented in COVID-19 long-haulers. Moreover, long lasting fatigue, mild cognitive impairment and sleep disorders appear to be frequent long term neurological manifestations after hospitalization due to COVID-19. Less is known in relation to peripheral nerve injury related to Sars-CoV-2 infection.

Case presentation

We report the case of a 47-year-old female presenting with a unilateral chest pain radiating to the left arm lasting for more than two months after recovery from Sars-CoV-2 infection. After referral to our post-acute outpatient service for COVID-19 long haulers, she was diagnosed with a unilateral, atypical, pure sensory brachial plexus neuritis potentially related to COVID-19, which occurred during the acute phase of a mild Sars-CoV-2 infection and persisted for months after resolution of the infection.

Conclusions

We presented a case of atypical Parsonage-Turner syndrome potentially triggered by Sars-CoV-2 infection, with symptoms and repercussion lasting after viral clearance. A direct involvement of the virus remains uncertain, and the physiopathology is unclear. The treatment of COVID-19 and its long-term consequences represents a relatively new challenge for clinicians and health care providers. A multidisciplinary approach to following-up COVID-19 survivors is strongly advised.

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan China. Lancet. 2020;395(10223):497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.CrossRefPubMedPubMedCentral

Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan. China JAMA Neurol. 2020;77(6):683–90. https://doi.org/10.1001/jamaneurol.2020.1127.CrossRefPubMed

Ellul MA, Benjamin L, Singh B, et al. Neurological associations of COVID-19. The Lancet Neurology. 2020;19(9):767–83. https://doi.org/10.1016/S1474-4422(20)30221-0.CrossRefPubMedPubMedCentral

Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA - Journal of the American Medical Association. 2020;324(6):603–5. https://doi.org/10.1001/jama.2020.12603.CrossRefPubMed

Wildwing T, Holt N. The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services. Therapeutic Advances in Chronic Disease. 2021;28(12):2040622320976979. https://doi.org/10.1177/2040622320976979.CrossRef

Siepmann T, Kitzler HH, Lueck C, Platzek I, Reichmann H, Barlinn K. Neuralgic amyotrophy following infection with SARS-CoV-2. Muscle Nerve. 2020;62(4):E68–70. https://doi.org/10.1002/mus.27035.CrossRefPubMed

Ismail II, Abdelnabi EA, Al-Hashel JY, Alroughani R, Ahmed SF. Neuralgic amyotrophy associated with COVID-19 infection: a case report and review of the literature. Neurol Sci. 2021;42(6):2161–5. https://doi.org/10.1007/s10072-021-05197-z.CrossRefPubMedPubMedCentral

Le MQ, Rosales R, Shapiro LT, Huang LY. The down Side of Prone Positioning: The Case of a Coronavirus 2019 Survivor. Am J Phys Med Rehabil. 2020;99(10):870–2. https://doi.org/10.1097/PHM.0000000000001530.CrossRefPubMed

Cacciavillani M, Salvalaggio A, Briani C. Pure sensory neuralgic amyotrophy in COVID-19 infection. Muscle Nerve. 2021;63(1):E7–8. https://doi.org/10.1002/mus.27083.CrossRefPubMed

10.

van Alfen N. Clinical and pathophysiological concepts of neuralgic amyotrophy. Nat Rev Neurol. 2011;7(6):315–22. https://doi.org/10.1038/nrneurol.2011.62.CrossRefPubMed

11.

Mitry MA, Collins LK, Kazam JJ, Kaicker S, Kovanlikaya A. Parsonage-turner syndrome associated with SARS-CoV2 (COVID-19) infection. Clin Imaging. 2021;72:8–10. https://doi.org/10.1016/j.clinimag.2020.11.017.CrossRefPubMed

12.

Mahajan S, Zhang F, Mahajan A, Zimnowodzki S. Parsonage Turner syndrome after COVID-19 vaccination. Muscle Nerve. 2021;64(1):E3–4. https://doi.org/10.1002/mus.27255.CrossRefPubMedPubMedCentral

13.

Wu Y, Xu X, Chen Z, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18–22. https://doi.org/10.1016/j.bbi.2020.03.031.CrossRefPubMedPubMedCentral

14.

Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci. 2020;11(7):995–8. https://doi.org/10.1021/acschemneuro.0c00122.CrossRefPubMed

15.

Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631–7. https://doi.org/10.1002/path.1570.CrossRefPubMedPubMedCentral

Title: COVID-19 atypical Parsonage-Turner syndrome: a case report
Authors: Maria Beatrice Zazzara
Anna Modoni
Alessandra Bizzarro
Alessandra Lauria
Francesca Ciciarello
Cristina Pais
Vincenzo Galluzzo
Francesco Landi
Matteo Tostato
Gemelli Against COVID-19 Post-Acute Care Team
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Turner's Syndrome
SARS-CoV-2
COVID-19
Published in: BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-022-02622-4

At a glance: The STEP trials

Springer Medicine

COVID-19 atypical Parsonage-Turner syndrome: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2022

Intra-cerebellar schwannoma with various degenerative changes: a case report and a systematic review

Godtfredsen syndrome – recurrent clival chondrosarcoma with 6 years follow up: a case report and literature review

Identification of ruptured intracranial aneurysms using the aneurysm-specific prediction score in patients with multiple aneurysms with subarachnoid hemorrhages- a Chinese population based external validation study

Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study

Characteristics of disease progression and genetic correlation in ambulatory Iranian boys with Duchenne muscular dystrophy

Uncommon cause of trigeminal neuritis and central nervous system involvement by herpes labialis: a case report