Cubital Tunnel Release in a Patient With Parsonage-Turner Syndrome: A Case Report

TL;DR

A patient with Parsonage-Turner syndrome also had ulnar nerve compression, requiring surgical treatment to relieve symptoms.

Contribution

This case report highlights the rare coexistence of Parsonage-Turner syndrome and ulnar nerve entrapment, suggesting double crush syndrome.

Findings

The patient exhibited symptoms consistent with both Parsonage-Turner syndrome and ulnar nerve compression.

Surgical decompression improved symptoms in a patient with overlapping neuropathies.

The case suggests the possibility of double crush syndrome in patients with PTS.

Abstract

Parsonage-Turner syndrome (PTS) is a rare peripheral neuropathy characterized by the sudden onset of shoulder pain followed by muscle weakness and atrophy. This condition primarily affects the brachial plexus and may mimic or coexist with other compressive neuropathies. We present a case of a 39-year-old female with a prior diagnosis of PTS who developed progressive right-sided scapular and elbow pain, accompanied by numbness in the fourth and fifth digits of the right hand. Her symptoms had been ongoing for approximately three months. Physical examination revealed atrophy of the intrinsic muscles of the right hand, a resting claw deformity, and positive Wartenberg and Tinel’s signs at the elbow. Electromyography (EMG) was consistent with C8-T1 brachial plexopathy and ulnar nerve entrapment. Given the persistence of symptoms despite conservative treatment, surgical decompression via cubital tunnel release and anterior subcutaneous ulnar nerve transposition was performed. This case illustrates the rare overlap of PTS and ulnar nerve compression, suggestive of double crush syndrome. It underscores the importance of maintaining a high index of suspicion for superimposed compressive neuropathies in patients with PTS who present with focal neurological deficits.