title: Incidence of neuralgic amyotrophy (Parsonage Turner syndrome) in a primary care setting--a prospective cohort study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, Donders Centre for Neuroscience, Radboud university medical centre, Nijmegen, The Netherlands.
authors.forename: Nens
authors.initials: N
authors.lastname: van Alfen
authors.affiliation: Department of Neurology, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
authors.forename: Jeroen J J
authors.initials: JJ
authors.lastname: van Eijk
authors.affiliation: Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Tessa
authors.initials: T
authors.lastname: Ennik
authors.affiliation: Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Sean O
authors.initials: SO
authors.lastname: Flynn
authors.affiliation: Primary Health Centre Oosterhout, Nijmegen, The Netherlands.
authors.forename: Inge E G
authors.initials: IE
authors.lastname: Nobacht
authors.affiliation: Department of Rehabilitation, Donders Centre for Neuroscience, Radboud university medical centre, Nijmegen, The Netherlands.
authors.forename: Jan T
authors.initials: JT
authors.lastname: Groothuis
authors.affiliation: Department of Neurology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Pillen
authors.affiliation: Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical centre, The Netherlands & Academic Health Centre Thermion, Lent, The Netherlands.
authors.forename: Floris A
authors.initials: FA
authors.lastname: van de Laar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020968:Brachial Plexus Neuritis / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology; D011320:Primary Health Care / Q000379:methods; D011446:Prospective Studies; D055815:Young Adult