PubMed · 2983236
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E W Massey. 1985. Common mononeuropathies.. https://pubmed.ncbi.nlm.nih.gov/2983236/
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A 45-year-old man developed ophthalmoplegia and subsequently multiple cranial nerve palsies in association with bibrachial paresis. Investigations revealed evidence of conduction block occurring at a very proximal location (i.e., the spinal roots) and seemingly sparing sensory fibers. Other causes were ruled out and a diagnosis of multifocal motor neuropathy with conduction block (MMN) was suggested. The patient responded to cyclophosphamide. Differentiating features between MMN and chronic inflammatory demyelinating polyradioneuropathy (CIDP) are discussed. This case demonstrates that MMN may rarely present with ophthalmoparesis and also demonstrates that features of MMN and CIDP may overlap.
Anatomical variations may be clinically significant, but many are inadequately described or quantified. Variations in neck anatomy are important to surgeons performing surgical procedures in this region. Thirty-two female and 19 male adult cadavers were studied. The commonly described anatomical relationship of the brachial plexus (BP) lying between the anterior scalene (AS) and middle scalene (MS) muscles was found in only 60% of instances. Scalenus minimus was present in 46% of instances (bilateral in 14 cadavers). The most common variation was the penetration of the AS by the C5 and/or C6 ventral rami. The C5 and C6 roots may fuse before piercing AS (15% cases, bilateral in 4 cadavers), or the C5 root alone pierce the belly of AS (13% cases, bilateral in 3 cadavers). The roots also may pierce AS independently (6% cases, bilateral in 1 cadaver). In 3%, the C5 root was found to be completely anterior to AS.
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