Difference between revisions of "Spinal accessory neuropathy"

(Created page with "==Background== *CN XI which innervates the sternocleidomastoid and trapezius muscles *Commonly removed during radical neck dissection for head and neck cancers ==Clinical Fe...")
 
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==Background==
 
==Background==
*CN XI which innervates the sternocleidomastoid and trapezius muscles
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[[File:Gray1210.png|thumb|Lateral neck, with accessory nerve seen between the sternocleidomastoid and trapezius muscles.]]
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*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
  
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===Causes===
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*Iatrogenic
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**Radical or modified neck dissection
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*Trauma
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*[[Stroke]]
  
 
==Clinical Features==
 
==Clinical Features==
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==Differential Diagnosis==
 
==Differential Diagnosis==
*Iatrogenic
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{{Upper extremity peripheral nerve syndromes}}
**Radical or modified neck dissection
 
*Trauma
 
*[[Stroke]]
 
  
 
==Evaluation==
 
==Evaluation==
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==Management==
 
==Management==
*NSAIDs
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*[[NSAIDs]]
 
*Shoulder sling
 
*Shoulder sling
 
*Physical therapy
 
*Physical therapy
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==See Also==
 
==See Also==
[[Neurologic exam]]
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*[[Neurologic exam]]
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*[[Peripheral nerve syndromes]]
  
 
==External Links==
 
==External Links==
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==References==
 
==References==
 
<references/>
 
<references/>
1. Kelley MJ et al. Spinal Accessory Nerve Palsy: Associated Signs and Symptoms. J Orthop Sport Phys. 2008;38(2):78-86.
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[[Category:Neurology]]

Latest revision as of 18:13, 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

Causes

  • Iatrogenic
    • Radical or modified neck dissection
  • Trauma
  • Stroke

Clinical Features

  • Trapezius atrophy
  • Weakness of shoulder abduction
  • Scapular dyskinesis

Differential Diagnosis

Upper extremity peripheral nerve syndromes

Median Nerve Syndromes

Ulnar Nerve Syndromes

Radial Nerve Syndromes

Proximal Neuropathies

Other

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

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