Incidence of neuralgic amyotrophy (Parsonage Turner syndrome) in a primary care setting--a prospective cohort study

Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting....

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Bibliographic Details
Published in:	PloS one Vol. 10; no. 5; p. e0128361
Main Authors:	van Alfen, Nens, van Eijk, Jeroen J J, Ennik, Tessa, Flynn, Sean O, Nobacht, Inge E G, Groothuis, Jan T, Pillen, Sigrid, van de Laar, Floris A
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 27-05-2015 Public Library of Science (PLoS)
Subjects:	Adolescent Adult Aged Aged, 80 and over Brachial Plexus Neuritis - diagnosis Brachial Plexus Neuritis - epidemiology Care and treatment Child Child, Preschool Codes Cohort analysis Complications Diagnosis Diagnostic systems Evaluation Female Genetic disorders Genetics Health care Hospitals Humans Immunoglobulins Incidence Infant Infant, Newborn Male Medical diagnosis Methods Middle Aged Muscular atrophy Neck Nervous system Neurologic Examination - methods Neurology Neurosciences Patients Peripheral nervous system Peripheral Nervous System Diseases - diagnosis Peripheral Nervous System Diseases - epidemiology Primary care Primary care nursing Primary Health Care - methods Prospective Studies Shoulder Turner's syndrome Vigilance Young Adult Netherlands
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Summary:	Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting. In a prospective cohort study during the year 2012 we registered all new cases of neck, shoulder or arm complaints from two large primary care centers serving a population of 14,118. Prior to study, general practitioners received a short training on how to diagnose classic neuralgic amyotrophy. Neuralgic amyotrophy was defined according to published criteria irrespective of family history. Only patients with a classic phenotype were counted as definite cases. After inclusion, patients with suspected neuralgic amyotrophy who had not yet seen a neurologist were offered neurologic evaluation for diagnostic confirmation. Of the 492 patients identified with new onset neck, shoulder or arm complaints, 34 were suspected of having neuralgic amyotrophy. After neurologic evaluation the diagnosis was confirmed in 14 patients. This amounts to a one-year incidence rate for classic neuralgic amyotrophy of 1 per 1000. Our findings suggest that neuralgic amyotrophy is 30-50 times more common than previously thought. Unawareness of the disorder and its clinical presentation seems the most likely explanation for this difference. An incidence rate of 1 per 1000 and the long-term sequelae many patients suffer warrant more vigilance in diagnosing the disorder, to pave the way for timely treatment and prevent complications.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conceived and designed the experiments: NvA JG FvdL. Performed the experiments: NvA JvE IN SP FvdL. Analyzed the data: NvA TE SOF. Wrote the paper: NvA JvE TE SOF IN JG SP FvdL. Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0128361