Spinal accessory neuropathy: Difference between revisions
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==Background== | ==Background== | ||
[[File:Gray1210.png|thumb|Lateral neck, with accessory nerve seen between the sternocleidomastoid and trapezius muscles.]] | |||
*CN XI which innervates the sternocleidomastoid and trapezius muscles<ref>Kelley MJ et al. Spinal Accessory Nerve Palsy: Associated Signs and Symptoms. J Orthop Sport Phys. 2008;38(2):78-86.</ref> | *CN XI which innervates the sternocleidomastoid and trapezius muscles<ref>Kelley MJ et al. Spinal Accessory Nerve Palsy: Associated Signs and Symptoms. J Orthop Sport Phys. 2008;38(2):78-86.</ref> | ||
*Commonly removed during radical neck dissection for head and neck cancers | *Commonly removed during radical neck dissection for head and neck cancers | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 18:06, 5 August 2020
Background
- CN XI which innervates the sternocleidomastoid and trapezius muscles[1]
- Commonly removed during radical neck dissection for head and neck cancers
Clinical Features
- Trapezius atrophy
- Weakness of shoulder abduction
- Scapular dyskinesis
Differential Diagnosis
- Iatrogenic
- Radical or modified neck dissection
- Trauma
- Stroke
Evaluation
- Usually a clinical diagnosis
- Positive scapular flip sign
- Outpatient EMG or nerve conduction studies
Management
- NSAIDs
- Shoulder sling
- Physical therapy
- Surgical repair
Disposition
- Discharge with neurology follow up
See Also
External Links
References
- ↑ Kelley MJ et al. Spinal Accessory Nerve Palsy: Associated Signs and Symptoms. J Orthop Sport Phys. 2008;38(2):78-86.