Difference between revisions of "Spinal accessory neuropathy"
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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> | *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=== | ||
| + | *Iatrogenic | ||
| + | **Radical or modified neck dissection | ||
| + | *Trauma | ||
| + | *[[Stroke]] | ||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
| − | + | {{Upper extremity peripheral nerve syndromes}} | |
| − | |||
| − | |||
| − | |||
==Evaluation== | ==Evaluation== | ||
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==Management== | ==Management== | ||
| − | *NSAIDs | + | *[[NSAIDs]] |
*Shoulder sling | *Shoulder sling | ||
*Physical therapy | *Physical therapy | ||
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==See Also== | ==See Also== | ||
| − | [[Neurologic exam]] | + | *[[Neurologic exam]] |
| + | *[[Peripheral nerve syndromes]] | ||
==External Links== | ==External Links== | ||
Latest revision as of 18:13, 5 August 2020
Contents
Background
- 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
- Radial neuropathy at the spiral groove (ie. "Saturday night palsy")
- Posterior interosseous neuropathy
Proximal Neuropathies
- Suprascapular neuropathy
- Long thoracic neuropathy
- Axillary neuropathy
- Spinal accessory neuropathy
- Musculocutaneous neuropathy
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
- ↑ Kelley MJ et al. Spinal Accessory Nerve Palsy: Associated Signs and Symptoms. J Orthop Sport Phys. 2008;38(2):78-86.