Difference between revisions of "Spinal accessory neuropathy"
(→Background) |
(→Management) |
||
(4 intermediate revisions by the same user not shown) | |||
Line 3: | Line 3: | ||
*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 | ||
+ | |||
+ | ===Causes=== | ||
+ | *Iatrogenic | ||
+ | **Radical or modified neck dissection | ||
+ | *Trauma | ||
+ | *[[Stroke]] | ||
==Clinical Features== | ==Clinical Features== | ||
Line 10: | Line 16: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
− | + | {{Upper extremity peripheral nerve syndromes}} | |
− | |||
− | |||
− | |||
==Evaluation== | ==Evaluation== | ||
Line 21: | Line 24: | ||
==Management== | ==Management== | ||
− | *NSAIDs | + | *[[NSAIDs]] |
*Shoulder sling | *Shoulder sling | ||
*Physical therapy | *Physical therapy | ||
Line 30: | Line 33: | ||
==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.