与 COVID-19 疫苗相关的颈椎根炎和帕森-特纳综合征:病例报告和文献综述。

Zachary C Taylor, Ravi S Nunna, Angela Tran, Matías Costa, Maxwell Gruber, Periklis Godolias, Zachary Litvack
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引用次数: 0

摘要

帕森纳-特纳综合征(Parsonage-Turner Syndrome)又称神经性肌萎缩症,是一种急性发作的上肢和肩腰麻痹症,可在病毒感染后、手术后或特发性情况下发生。也有一些关于接种疫苗后发生该综合征的病例报道。神经痛性肌萎缩症的病理生理学尚不完全清楚,我们在诊断该综合征时常用的许多影像学诊断方法都不准确,容易产生误导。我们介绍了一例 40 岁的男性病例,他在接种第二剂辉瑞生物技术公司生产的 COVID-19 疫苗后出现急性发作的右上肢灼痛和筋膜炎。他的症状发展为孤立肌群无力,肌电图显示神经传导能力下降。颈椎核磁共振成像显示颈椎中心和椎间孔多层次狭窄,提示诊断为颈椎病。患者接受了 C4-5/C5-6 和 C6-7 椎板切除术,术后恢复良好。术后,患者症状逐渐改善,但仍有右侧肱三头肌和胸肌无力以及右肘和前臂麻痹的症状。帕森纳-特纳综合征是一种臂丛神经麻痹,可影响臂丛神经的一个或多个分支。它会导致急性发作的疼痛和无力,而常用的影像诊断方法很难对其做出诊断。我们回顾了有关接种疫苗后神经痛性肌萎缩的其他病例报告以及有关更准确的影像学诊断方法的现有文献,这些方法可能有助于我们诊断和了解这种疾病的病理生理学。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19 Vaccine Related Cervical Radiculitis and Parsonage-Turner Syndrome: Case Report and Review of the Literature.

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.

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