Difference between revisions of "Spinal accessory neuropathy"

(Background)
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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

Lateral neck, with accessory nerve seen between the sternocleidomastoid and trapezius muscles.
  • 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

Neurologic exam

External Links

References

  1. Kelley MJ et al. Spinal Accessory Nerve Palsy: Associated Signs and Symptoms. J Orthop Sport Phys. 2008;38(2):78-86.