COVID-19 Vaccine Related Cervical Radiculitis and Parsonage-Turner Syndrome: Case Report and Review of the Literature.

Publication Title

Turk Neurosurg

Authors

Zachary C Taylor, Swedish Neuroscience Institute, Department of Neurosurgery, Seattle, WA, USA.Follow
Ravi S Nunna, Department of Neurosurgery, Swedish Medical Center (Seattle, WA 98122)Follow
Angela Tran, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington, USAFollow
Matias Costa, Cerebrovascular Neurosurgery Department, Swedish Neuroscience Institute, Seattle, WA 98122, USAFollow
Maxwell Gruber, Swedish Neuroscience Institute, Department of Neurosurgery, Seattle, WA, USA.Follow
Periklis Godolias, Swedish Neuroscience Institute, Department of Neurosurgery, Seattle, WA, USA.Follow
Zachary Litvack, Swedish Neuroscience Institute, Seattle Science Foundation, Seattle, USA.Follow

Document Type

Article

Publication Date

1-1-2024

Keywords

washington; swedish; swedish neuro; covid-19; Male; Humans; Adult; Brachial Plexus Neuritis; Radiculopathy; COVID-19 Vaccines; BNT162 Vaccine; COVID-19; Paralysis

Abstract

Parsonage-Turner Syndrome, or neuralgic amyotrophy, is an acute-onset upper limb and shoulder girdle palsy that can occur in a post-viral, post-surgical or idiopathic setting. There have also been some reported cases of the syndrome occurring following vaccinations. The pathophysiology of neuralgic amyotrophy is not completely understood and many of the commonly used diagnostic imaging modalities we use to try and diagnose this syndrome are inaccurate and misleading. We present the case of a 40-year-old gentleman who presented with acute onset burning pain and fasciculations in his right upper extremity following vaccination with the second dose of the Pfizer-BioNTech COVID-19 vaccine. His symptoms progressed to weakness in isolated muscle groups with electromyographic evidence of decreased nerve conduction. MRI of the cervical spine demonstrated multilevel central and foraminal stenosis, suggesting a diagnosis of cervical radiculopathy. The patient underwent a C4-5/C5-6 and C6-7 laminoforaminotomy and tolerated the procedure well. Post-operatively, the patient has experienced gradual symptom improvement with residual right triceps and pectoralis muscle weakness as well as paresthesias of the right elbow and forearm. Parsonage-Turner Syndrome is a brachial plexus palsy that can affect one or multiple branches of the brachial plexus. It causes acute-onset pain and weakness, and the diagnosis can be difficult to make with the commonly used diagnostic imaging methods. We reviewed other case reports about neuralgic amyotrophy following vaccinations as well as the current literature on more accurate diagnostic imaging modalities that may help our diagnosis and understanding of the pathophysiology of this condition.

Clinical Institute

Neurosciences (Brain & Spine)

Specialty/Research Institute

Neurosciences

Specialty/Research Institute

Infectious Diseases

DOI

10.5137/1019-5149.JTN.44533-23.2