Diagnosis of unilateral trapezius muscle palsy: 54 Cases

Abstract

There were 5 main diagnostic findings in unilateral TM palsy: (1) dynamic examination of the scapula provides a new clinical sign; (2) NA is the most frequent medical cause; (3) in medical cases, partial preservation of the upper TM can offer good recovery; (4) FSH must be considered, especially in young patients; and (5) minor neck surgery can lead to severe TM palsy. Muscle Nerve 56: 215-223, 2017.

Unilateral winged scapula: Clinical and electrodiagnostic experience with 128 cases, with special attention to long thoracic nerve palsy

“…Five cases with LTN palsy also exhibited ipsilateral SAN palsy, related to NA ( n = 3), postradiation brachial plexopathy ( n = 1), and thoracic surgery for breast cancer surgery ( n = 1). Among the 39 SAN lesions, 26 were related to a medical cause and 13 to neck surgery . The 26 medical causes were: neuralgic amyotrophy ( n = 20); idiopathic or posttraumatic condition ( n = 3); postradiation neuropathy ( n = 1); abnormal vascular loop of the jugular vein ( n = 1); and chest cancer ( n = 1).…”

“…The 13 surgical causes were: cervical lymph node biopsy ( n = 3); oncologic neck surgery ( n = 6); cervicofacial lift ( n = 2); carotid and vertebral bypass ( n = 1); and a retroauricular wound ( n = 1). Five cases were mild FSH …”

“…Data were collected on age, gender, right‐ or left‐handedness, duration of symptoms before EDX, the circumstances of occurrence (surgical procedure, trauma, radiotherapy, or other precipitating conditions), and the physical examination. The physical examination systematically involved a comparative static examination of both shoulders at rest, front and back view, then a comparative dynamic analysis of the scapulothoracic rhythm of the back view during large circumduction of both upper limbs . The assessment also evaluated muscle wasting and strength of the infraspinatus, serratus anterior, trapezius, deltoid, biceps, and triceps muscles, and tendon reflex testing of the upper limbs.…”

“…In 2002, Friedenberg et al . and Seror et al ., in 2017, reported 2 large series of SAN palsy. Many cases of both LTN and SAN palsy, related to neuralgic amyotrophy (NA), have been reported .…”

“…and Seror et al ., in 2017, reported 2 large series of SAN palsy. Many cases of both LTN and SAN palsy, related to neuralgic amyotrophy (NA), have been reported . Some series were specifically related to LTN or serratus anterior muscle palsy, and most have been from orthopedic surgical teams; the largest series of isolated LTN palsy included 197 cases …”