{"id":2629,"date":"2025-02-08T21:30:02","date_gmt":"2025-02-08T20:30:02","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=2629"},"modified":"2026-01-02T00:10:26","modified_gmt":"2026-01-01T23:10:26","slug":"nevralgie-tronculaire","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=2629","title":{"rendered":"N\u00e9vralgie tronculaire (Parsonage Turner)"},"content":{"rendered":"\n
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Syndrome de Parsonage-Turner<\/strong><\/p>\n\n\n\n

D\u00e9finition <\/strong>: syndrome neurologique, r\u00e9sultant d’une inflammation (ayant une composante probablement auto-immune) de cause inconnue du plexus-brachial. Il peut \u00e9galement toucher d’autres nerfs et racines. Il associe une douleur tr\u00e8s intense, une amyotrophie et une faiblesse musculaire faisant suite \u00e0 cette douleur.<\/p>\n\n\n\n

Manifestations cliniques <\/strong>
Tr\u00e8s h\u00e9t\u00e9rog\u00e8ne, mais globalement, les sympt\u00f4mes seront au niveau de la localisation du nerf.
Signes de perte et gain de fonction douleur, trouble de l\u2019\u00e9quilibre, paresth\u00e9sie, hypoesth\u00e9sie, fatigue musculaire, amyotrophie, crampe, fasciculation,…
Douleur au niveau de l’\u00e9paule cons\u00e9cutif \u00e0 l’amyotrophie qui a un impact m\u00e9canique.<\/p>\n<\/div>\n\n\n\n

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\"\"<\/a><\/figure>\n<\/div>\n<\/div>\n\n\n\n
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Facteurs de risque<\/strong>
– Apr\u00e8s chirurgie
– Suite \u00e0 une grossesse ou maternit\u00e9
– A proximit\u00e9 d’une vaccination
– Apr\u00e8s infection (mycose, zona, grippe, herp\u00e8s)
– Li\u00e9e \u00e0 la consommation de toxique (drogue, produits de contraste, radioth\u00e9rapie)
– Notion d’h\u00e9r\u00e9dit\u00e9
– Li\u00e9e \u00e0 des pathologies rhumatismales
– Apr\u00e8s certains traumatisme, chutes
– En lien avec le syst\u00e8me immunitaire<\/p>\n<\/div>\n\n\n\n

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Epid\u00e9miologie<\/strong>
– H > F
– 1 \u00e0 3 pour 100 000 mais s\u00fbrement sous-estim\u00e9e
– Age : 30 \u00e0 70 ans<\/p>\n<\/div>\n<\/div>\n\n\n\n

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Physiopathologie<\/strong>
Physiopathologie m\u00e9connue mais dans tous les cas, le syst\u00e8me nerveux est impact\u00e9 par d\u00e9faillance immunitaire et en lien avec le syst\u00e8me inflammatoire et vasculaire.
Deux hypoth\u00e8ses :
– Trouble de l’immunit\u00e9<\/strong> (composante inflammatoire, vasculaire, immunitaire). Le syst\u00e8me inflammatoire\/immunitaire va dysfonctionner et agresser les nerfs p\u00e9riph\u00e9riques.
– Hypoth\u00e8se isch\u00e9mique<\/strong> (composante vasculaire)<\/p>\n\n\n\n

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Diagnostic diff\u00e9rentiel<\/strong>
Quelles autres pathologies peuvent provoquer une n\u00e9vralgie ?<\/p>\n\n\n\n

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Neuropathie diab\u00e9tique<\/strong>
Polyneuropathie, atteinte disto-proximale en chaussette, sym\u00e9trique. Paresth\u00e9sie, atteintes motrices, crampes.
Mononeuropathie\/monon\u00e9vrite : douleurs localis\u00e9es, atteintes motrices, limitations fonctionnelles. Apparition soudaine et r\u00e9solution spontan\u00e9e en quelques mois<\/p>\n\n\n\n

Neuropathie \u00e9thylique<\/strong>
Polyneuropathie distale et sym\u00e9trique, amyotrophie homog\u00e8ne qui cr\u00e9e des douleurs en lien avec les tendons. R\u00e9flexes anormaux, hypoesth\u00e9sie ou hypoalg\u00e9sie distale.<\/p>\n\n\n\n

Insuffisance r\u00e9nale chronique<\/strong>
Polyneuropathie non sp\u00e9cialis\u00e9e \u00e0 un tronc et expression clinique tr\u00e8s variable. R\u00e9orienter vers un n\u00e9phrologue car cela peut \u00eatre le signe d’une aggravation de la pathologie r\u00e9nale.<\/p>\n\n\n\n

Chimioth\u00e9rapie<\/strong>
Polyneuropathie en chaussette et en gant. 1\u00e8re cause qui entra\u00eene l’arr\u00eat du traitement. Douleurs neuro tr\u00e8s pr\u00e9sentes, sensitive>motrice. La neuropathie peut \u00e9voluer encore plusieurs mois voire ann\u00e9es apr\u00e8s l’arr\u00eat du traitement.<\/p>\n\n\n\n

<\/p>\n<\/div>\n\n\n\n

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Hypothyro\u00efdie<\/strong>
Polyneuropathie non syst\u00e9matis\u00e9. Fatigu, prise de poids, crampes, dysm\u00e9norrh\u00e9es, probl\u00e8me digestif, m\u00e9moire,…
Prise de sang pour mettre en \u00e9vidence.<\/p>\n\n\n\n

Polyneuropathie<\/strong>
Etiologie tr\u00e8s variable, atteinte sym\u00e9trique distale, atteinte de plusieurs troncs et bilat\u00e9rale.<\/p>\n\n\n\n

Neuropathie scapulaire<\/strong>
Atteinte variable caus\u00e9es par des traumas ou micro-trauma du nerf suprascapulaire dans un contexte de mouvements r\u00e9p\u00e9r\u00e9s au-dessus de la t\u00eate, surtout chez les sportifs.<\/p>\n\n\n\n

Radiculopathie cervicale<\/strong>
Trouble de la conduction nerveuse, atteinte sensitive et\/ou motrice. Les territoires sont en lien avec une racine sp\u00e9cifique.<\/p>\n\n\n\n

Syndrome sub-acromial<\/strong>
Douleur d’\u00e9paule qui regroupe diff\u00e9rentes entit\u00e9s. Peut produire une irradiation de douleur, pas d’atteinte de la fonction neuro.<\/p>\n\n\n\n

Syndrome douloureux r\u00e9gional complexe<\/strong>
Douleur spontan\u00e9e ou provoqu\u00e9e, comportement non m\u00e9canique, ne suit pas de territoire tronculaire ou radiculaire.<\/p>\n<\/div>\n<\/div>\n\n\n\n

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Diagnostic clinique<\/strong><\/p>\n\n\n\n

Atteinte centrale <\/strong>: \u00e0 v\u00e9rifier avant de passer \u00e0 la suite.
Poser les 9 questions : 5D 3N 1A (diplopie, dysarthrie, dysphagie, drop attack, dysness, nystagmus, numbness, naus\u00e9e, ataxie)<\/p>\n\n\n\n

Examen clinique<\/strong>
Examen neurologique p\u00e9riph\u00e9rique de routine tr\u00e8s rigoureux<\/p>\n\n\n\n

Paraclinique<\/strong>
EMG : objectivation des alt\u00e9rations de la conduction neurale, surtout dans l’atteinte des grosses fibres. <\/p>\n\n\n\n

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Th\u00e9rapeutique<\/strong><\/p>\n\n\n\n

Douleurs radiculaires\/tronculaires<\/strong>
– Exercice de contr\u00f4le moteur \u00e0 court terme et exercice physique global \u00e0 long terme.
– Hygi\u00e8ne de vie \u00e0 moyen-long terme
– Int\u00e9r\u00eat d’une prise en charge neurodynamique<\/p>\n\n\n\n

Handicap en contexte de douleur radiculaire<\/strong><\/p>\n\n\n\n

En condition chronique de douleur, il est difficile de r\u00e9cup\u00e9rer la fonction.
La fonction est plus r\u00e9sistance aux changements que la douleur.<\/p>\n\n\n\n

Sur la fonction<\/strong>
– Renforcement sur muscles d\u00e9ficitaires sauf si d\u00e9nervation compl\u00e8te
– Electroth\u00e9rapie pour atteinte de plus de 4 mois. Attention \u00e0 la surstimulation qui peut \u00eatre d\u00e9l\u00e9t\u00e8re. Veiller \u00e0 ne pas avoir de majorations de signes et sympt\u00f4mes en post exo.
Education au patient<\/strong>
– Traitement antalgique sur le long terme : conseil hygi\u00e8ne de vie sur le sommeil, pratique d’activit\u00e9 physique, nutrition.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Syndrome de Parsonage-Turner D\u00e9finition : syndrome neurologique, r\u00e9sultant d’une inflammation (ayant une composante probablement auto-immune) de cause inconnue du plexus-brachial. Il peut \u00e9galement toucher d’autres nerfs et racines. Il associe une douleur tr\u00e8s intense, une…<\/p>\n

Continue Reading \u00ab\u00a0N\u00e9vralgie tronculaire (Parsonage Turner)\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[412,359],"tags":[],"class_list":["post-2629","post","type-post","status-publish","format-standard","hentry","category-champ-neuro-autres","category-pathologie-epaule"],"yoast_head":"\nN\u00e9vralgie tronculaire (Parsonage Turner) - wikine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kineaphp.fr\/?p=2629\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"N\u00e9vralgie tronculaire (Parsonage Turner) - wikine\" \/>\n<meta property=\"og:description\" content=\"Syndrome de Parsonage-Turner D\u00e9finition : syndrome neurologique, r\u00e9sultant d’une inflammation (ayant une composante probablement auto-immune) de cause inconnue du plexus-brachial. 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