Hi everyone
I need help with this case please.
M40, no prior neurological history.
4 months ago acute “chest infection” for 2 weeks with high fever and severe coughing.
Onset of right arm/shoulder pain 1-2 weeks into the infection.
Cessation of pain after 1-2 weeks, with progressive axillary nerve sensomotoric deficit and by now visible atrophy of deltoid muscle.
MRI done at some point in September was reported as "concerning for brachial neuritis"…. to my mind it shows indeed signal and caliber changes along the right C5 root and the axillary nerve, without a definite discontinuity. The neurologist asked specifically about "hour-glass constrictions"…. I don’t see that either.
I’m attaching a PPT with the 3D Cube STIR scans…. the rest of the study doesn’t carry much information, in my opinion…. but I can send more images if needed.
What is your impression? Parsonage-Turner?
Immune / infection related?
Any recommended course of action at this stage? Would corticosteroids help this late? Or just physical therapy and hope for the best?
Any idea is more than welcome. Thanks a lot, and have a great day!
Cheers,
Andrei
