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Musculoskeletal and Sports Medicine

A Twisted Turn: Parsonage-Turner Syndrome and Spinal Accessory Neuropathy after COVID Infection - A Case Report

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 3

    Primary Author(s)

  • Aimee Abbott-Korumi, DO

    Physiatry Resident
    JFK Medical Center PM&R Program
    Edison, New Jersey

    • Co-Author(s)

  • MG

    Michael Galibov, DO

    Chief Resident
    JFK Medical Center PM&R Program
    Woodbridge, New Jersey

  • AS

    Alexander Shustorovich, DO

    Associate Program Director
    JFK Johnson Rehabilitation Institute At the Center for Sports and Spine Medicine
    Edison, New Jersey

  • David Brown, DO

    Clinical Professor of Physical Medicine and Rehabilitation
    JFK Johnson Rehabilitation Institute
    Clinton, New Jersey

Disclosure(s):
Aimee Abbott-Korumi, DO: No financial relationships to disclose
David Brown, DO: No financial relationships to disclose
Case Diagnosis: Parsonage-Turner Syndrome (PTS) and Spinal Accessory Neuropathy after COVID infection.

Case Description or Program Description: A 40-year-old male presented with a history of contracting COVID twice within two months, one year prior to presentation. Following the infections, he developed severe pain in his right occiput radiating into his right upper extremity, including his middle and ring fingers. Over the following year, his pain pattern became localized to his lower trapezius and scapula, accompanied by diminished right shoulder abduction. Physical exam revealed right shoulder depression, trapezius atrophy, and lateral winging of the scapula, with preserved strength and sensation in the right upper extremity. Given the history of COVID infection and evolving symptoms, an MRI of the brachial plexus and Electromyography (EMG)/Nerve Conduction Study (NCS) were ordered for further evaluation.

Setting: Outpatient Rehabilitation Medicine

Assessment/Results: EMG findings showed fibrillations and positive waves in the right upper, middle, and lower trapezius muscles, with no motor units firing, consistent with severe right spinal accessory neuropathy (Parsonage Turner Syndrome). The patient was referred to a plastic surgeon for further evaluation and consideration of potential interventions to aid in symptom resolution.

Discussion (relevance): Parsonage-Turner Syndrome (PTS), also known as Neuralgic Amyotrophy, is a rare neurological disorder characterized by abrupt upper extremity pain followed by neurological deficits. It has been linked to trauma, surgery, and viral infections, including COVID. While PTS commonly affects the upper trunk of the brachial plexus, long thoracic, suprascapular, and axillary nerves, involvement of the spinal accessory nerve is less frequent. This case contributes to the growing body of evidence linking COVID infection with PTS, particularly with spinal accessory neuropathy.

Conclusions: This case illustrates a rare presentation of PTS involving the spinal accessory nerve following COVID infection, emphasizing the importance of recognizing this uncommon target of neuralgic amyotrophy and to consider a range of nerve pathologies in post-COVID patients.