Isolated spinal accessory mononeuropathy associated with neurogenic muscle hypertrophy: restricted neuralgic amyotrophy or stretch-palsy? A case report.

Abstract

A 55-year-old man developed transient bi-brachial paresthesias followed by severe pain over his left shoulder ridge and periscapular region within 8 hours of rigorous hand-over-hand hoisting of a 33.8-kg (75-lb) object. He experienced weakness in shoulder abduction followed several weeks later by focal hypertrophy of the left trapezius. Electrophysiologic studies showed significant spontaneous motor activity in the form of denervation potentials, fasciculations, and complex repetitive discharges. The 2 major diagnostic considerations were restricted neuralgic amyotrophy versus stretch palsy of the spinal accessory nerve. The clinical similarities and differences between restricted forms of neuralgic amyotrophy and stretch palsies are discussed.

• Authors: Steven K Baker
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 89 Issue 3 Pg. 559-63 (Mar 2008) ISSN: 1532-821X [Electronic] United States
• PMID: 18295637 (Publication Type: Case Reports, Journal Article)

Topics

• Accessory Nerve (physiopathology)
• Brachial Plexus Neuritis (diagnosis)
• Diagnosis, Differential
• Electromyography
• Follow-Up Studies
• Humans
• Hypertrophy (pathology)
• Male
• Middle Aged
• Mononeuropathies (diagnosis)
• Muscle, Skeletal (pathology)
• Pain Measurement
• Paralysis (diagnosis)
• Risk Assessment
• Severity of Illness Index
• Shoulder Injuries