Parsonage–Turner Syndrome in a major burns patient☆

The patient concerned was a 36-year-old right-handed male who suffered 35% total body surface area burns (10% full thickness) post-self-immolation, affecting his face, anterior neck and torso, bilateral arms and left leg. He had no significant past medical history apart from depression and there was no history of alcohol dependence. He was admitted for a total of 42 days and spent 13 days in the intensive care unit, intubated and ventilated for 12 of these. On admission, he was significantly hypothermic and acidotic. Escharotomies of bilateral forearms and left thigh were performed within 21/ 2 h of admission (Fig. 1). Debridement and skin grafting was carried out on day 8 and day 26. His clinical course was complicated early by episodes of sepsis requiring inotropic support, coagulopathy, neutropaenia, acute respiratory distress syndrome and electrolyte disturbances. Once stable on the ward he made progressive recovery until discharge on day 42. One month after discharge, he re-presented with a history of acute pain and weakness in his right shoulder without obvious provocation. He described waking at 2 a.m. with a sharp pain in his shoulder but was able to move it normally. With simple analgesia he went back to sleep to wake 6 h later pain free but with weakness of his right shoulder. On examination, he had weakness of right shoulder abduction, and external rotation with power grade 0–1/5 (Fig. 2). He had