Phrenic nerve palsy: Cervical spine stenosis or Parsonage and Turner syndrome? A case series and review of the literature.
5 affiliations
- 1Department of Emergency Medicine, CHR Verviers, rue du Parc 29, 4800, Verviers, Belgium.
- 2Department of Neurosurgery CHU Liège, Domaine Universitaire du Sart Tilman, B35, Liège, 4000, Belgium.
- 3Department of Neurology CHU Liège, Domaine Universitaire du Sart Tilman, B35, Liège, 4000, Belgium.
- 4Department of Pneumology, Domaine Universitaire du Sart Tilman, B35, CHU Liège, Liège, 4000, Belgium.
- 5Department of Respiratory Medicine, University hospital of Liège, GIGA research group, University of Liège, Liège, 4000, Belgium.
Abstract
Introduction
Phrenic nerve palsy is a rare cause of dyspnea. The differential diagnosis between cervical spine stenosis and Parsonage and Turner syndrome (PTS), the 2 main causesof phrenic nerve palsy, can be challenging.Research question
How to differentiate cervical spine osteoarthritis from PTS in front of a patient with phrenic nerve palsy?Material and methods
We retrospectively reviewed 8 patients suffering from phrenic nerve palsy. Clinical presentation, imaging, and electrophysiological data are analyzed. A literature review is conducted to support the diagnostic management.Results
The 8 patients, 5 men and 3 women, were 36 to 78 year-old. Six patients presented with acute or subacute onset of symptoms, and clinical as well as electrophysiological features were consistent with PTS. In 3 of them, Magnetic Resonance neurography demonstrated hourglass constrictions along the phrenic nerve. No surgery was performed, and they all had a favourable outcome following conservative treatment. In one patient, cervical foraminal stenosis was clearly implicated, with rapid improvement after decompressive surgery. In another case, cervical surgery was performed on severe C3C4 and C4C5 osteophytic changes with no significant clinical improvement; the rapid elevation of the hemidiaphragm over six weeks and the prior recurrent febrile/inflammatory episodes raise doubts in retrospect about the cervical compressive etiology.Discussion and conclusion
Phrenic nerve palsy results mostly from PTS or cervical spine stenosis, requiring distinct diagnostic and therapeutic strategies. A careful clinical, biological, electrophysiological and radiological assessment is essential to distinguish between these entities and provide timely and appropriate management.
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BibTeX
@article{hosseini2026phrenic,
title = {{Phrenic nerve palsy: Cervical spine stenosis or Parsonage and Turner syndrome? A case series and review of the literature.}},
author = {Clémence Hosseini and Gilles Reuter and Manon Hustinx and Fanny Gester and Julien Guiot and Annie Dubuisson},
journal = {Brain \& spine},
year = {2026},
month = sep,
doi = {10.1016/j.bas.2026.107450},
url = {https://europepmc.org/article/MED/42898160},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Phrenic nerve palsy: Cervical spine stenosis or Parsonage and Turner syndrome? A case series and review of the literature.
AU - Clémence Hosseini
AU - Gilles Reuter
AU - Manon Hustinx
AU - Fanny Gester
AU - Julien Guiot
AU - Annie Dubuisson
PY - 2026
DA - 2026/09/28
JO - Brain & spine
DO - 10.1016/j.bas.2026.107450
UR - https://europepmc.org/article/MED/42898160
AB - Introduction Phrenic nerve palsy is a rare cause of dyspnea. The differential diagnosis between cervical spine stenosis and Parsonage and Turner syndrome (PTS), the 2 main causesof phrenic nerve palsy, can be challenging.Research question How to differentiate cervical spine osteoarthritis from PTS in front of a patient with phrenic nerve palsy?Material and methods We retrospectively reviewed 8 patients suffering from phrenic nerve palsy. Clinical presentation, imaging, and electrophysiological data are analyzed. A literature review is conducted to support the diagnostic management.Results The 8 patients, 5 men and 3 women, were 36 to 78 year-old. Six patients presented with acute or subacute onset of symptoms, and clinical as well as electrophysiological features were consistent with PTS. In 3 of them, Magnetic Resonance neurography demonstrated hourglass constrictions along the phrenic nerve. No surgery was performed, and they all had a favourable outcome following conservative treatment. In one patient, cervical foraminal stenosis was clearly implicated, with rapid improvement after decompressive surgery. In another case, cervical surgery was performed on severe C3C4 and C4C5 osteophytic changes with no significant clinical improvement; the rapid elevation of the hemidiaphragm over six weeks and the prior recurrent febrile/inflammatory episodes raise doubts in retrospect about the cervical compressive etiology.Discussion and conclusion Phrenic nerve palsy results mostly from PTS or cervical spine stenosis, requiring distinct diagnostic and therapeutic strategies. A careful clinical, biological, electrophysiological and radiological assessment is essential to distinguish between these entities and provide timely and appropriate management.
SN - 2772-5294
ER -