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Results for “Accessory Nerve Diseases”

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At least 19 recordsLinked to original sources
PubMed2006

Clinical signs of accessory nerve palsy.

BACKGROUND: Injury to the spinal accessory nerve causes paralysis of the trapezius muscle, which is a painful and disabling condition. Many injuries are iatrogenic. Diagnosis is often made after a long delay, suggesting that current clinical signs are inadequate. METHODS: Accessory nerve palsy is known to be a cause of winging of the scapula. Observation of six patients with accessory nerve palsy has shown that winging of the scapula is most prominent when the patient actively externally rotates the shoulder against resistance. RESULTS: This is in contrast to the other causes of winging of the scapula including long thoracic nerve palsy and muscular dystrophy, where the scapula is most prominent on flexion or abduction of the shoulder. CONCLUSION: We propose that the resisted active external rotation test should be regarded as the key clinical sign for accessory nerve palsy.

Accessory Nerve Diseases↗
PubMed2002

Spinal accessory mononeuropathy following posterior fossa decompression surgery.

Isolated injury of the spinal accessory nerve is a well-recognized complication of surgeries involving the posterior triangle of the neck. The procedures most commonly implicated are lymph node biopsy and carotid endarterectomy. We present a patient with isolated injury to the spinal accessory nerve, localized proximal to the innervation of the sternocleidomastoid muscle, which was noted following suboccipital decompression for an Arnold-Chiari malformation. To our knowledge, this association has not been previously reported.

Accessory Nerve↗
PubMed2002

The natural history of long thoracic and spinal accessory neuropathies.

A cohort of 106 patients with electrodiagnostically confirmed long thoracic neuropathy (50 patients) or spinal accessory neuropathy (56 patients) seen at the Mayo Clinic over a 22-year period were retrospectively studied to better understand the natural history of these disorders and to determine the role of electrodiagnostic testing in predicting prognosis. Mean follow-up was 48 and 50 months, respectively. Good functional recovery was generally observed regardless of the results of electrodiagnostic studies, but improvement in the amplitude of the spinal accessory compound muscle action potential on serial nerve conduction studies tended to predict a good outcome. No electrodiagnostic findings correlated with poor outcome. Traumatic neuropathies generally did worse than neuropathies of other causes. In spinal accessory neuropathies, involvement of the dominant limb, scapular winging, and impaired arm elevation were associated with a poor outcome. Our data suggest that, contrary to other focal neuropathies, the electrodiagnostic findings do not predict functional outcome in these neuropathies.

Accessory Nerve↗
PubMed2003

Spinal accessory neuropathy, droopy shoulder, and thoracic outlet syndrome.

Droopy shoulder has been proposed as a cause of thoracic outlet syndrome. Two patients developed manifestations of neurovascular compression upon arm abduction, associated with unilateral droopy shoulder and trapezius muscle weakness caused by iatrogenic spinal accessory neuropathies following cervical lymph node biopsies. The first patient developed a cold, numb hand with complete axillary artery occlusion when his arm was abducted to 90 degrees. The second patient complained of paresthesias in digits 4 and 5 of the right hand, worsened by elevation of the arm, with nerve conduction findings of right lower trunk plexopathy (low ulnar and medial antebrachial cutaneous sensory nerve action potentials). Spinal accessory nerve grafting (in the first patient) coupled with shoulder strengthening physical exercises in both patients resulted in gradual improvement of symptoms in 2 years. These two cases demonstrate that unilateral droopy shoulder secondary to trapezius muscle weakness may cause compression of the thoracic outlet structures.

Accessory Nerve↗
PubMed2000

[Neuropathies of the spinal accessory nerve secondary to cervical surgery: clinical and electrophysiological study of 7 cases].

After innervating the sternocleidomastoid muscle, the spinal accessory nerve emerges and down crosses the posterior cervical triangle to innervate the trapezius. At the posterior triangle, the nerve is closely related to local lymph nodes and may be injured by their enlargement or surgical removal. Injury to this nerve is uncommom. Most cases are iatrogenically due to surgical procedures in the posterior cervical triangle, often following lymph nodes biopsies or benign turmors approaches. We present seven cases of post-surgical related spinal accessory nerve injury and discuss its clinical and electrophysiologycal profiles. The major motor signs were shoulder drop and paresis to raise arm. Pain and sensory complaints were almost universal and most probably due to concomitant injury of cervical plexus cutaneous branches, which are in direct relation to the spinal accessory nerve in the posterior cervical triangle. Lesion type is usually axonotmesis, but varied degrees of compression by cicatricial spurs are observed in some patients. Surgical approach and nerve repair must be considered for pacients with delayed recovery.

Accessory Nerve Diseases↗
PubMed2001

Physical therapy for spinal accessory nerve injury complicated by adhesive capsulitis.

BACKGROUND AND PURPOSE: The authors found no literature describing adhesive capsulitis as a consequence of spinal accessory nerve injury and no exercise program or protocol for patients with spinal accessory nerve injury. The purpose of this case report is to describe the management of a patient with adhesive capsulitis and spinal accessory nerve injury following a carotid endarterectomy. CASE DESCRIPTION: The patient was a 67-year-old woman referred for physical therapy following manipulation of the left shoulder and a diagnosis of adhesive capsulitis by her orthopedist. Spinal accessory nerve injury was identified during the initial physical therapy examination, and a program of neuromuscular electrical stimulation was initiated. OUTCOMES: The patient had almost full restoration of the involved muscle function after 5 months of physical therapy. DISCUSSION: This case report illustrates the importance of accurate diagnosis and suggests physical therapy intervention to manage adhesive capsulitis as a consequence of spinal accessory nerve injury.

Accessory Nerve Diseases↗
PubMed2001

Complications of deep brain stimulation surgery.

Although technological advances have reduced device-related complications, DBS surgery still carries a significant risk of transient and permanent complications. We report our experience in 86 patients and 149 DBS implants. Patients with Parkinson's disease, essential tremor and dystonia were treated. There were 8 perioperative, 8 postoperative, 9 hardware-related complications and 4 stimulation-induced side effects. Only 5 patients (6%) sustained some persistent neurological sequelae, however, 26 of the 86 patients undergoing 149 DBS implants in this series experienced some untoward event with the procedure. Although there were no fatalities or permanent severe disabilities encountered, it is important to extend the informed consent to include all potential complications.

Accessory Nerve Diseases↗
PubMed2003

Bilateral meningiomatous lesions of the spinal accessory nerves.

BACKGROUND: Meningiomas arising from cranial nerves with no dural attachment are exceedingly rare. The authors present a patient with bilateral meningiomatous lesions originating symmetrically from both spinal accessory nerves. CASE REPORT: A 61-year old woman presented with a one-year history of spinal ataxia and minimal left-sided motor impairment. Magnetic resonance imaging demonstrated two extrinsic lesions dorsolaterally of the medulla. Surgical exposure via a midline suboccipital approach with C1 laminectomy revealed the lesions arising from the spinal accessory nerves and in direct contact with the vertebral arteries. Histological investigation showed hypocellular fibrous lesions with proliferating meningothelial cells, psammoma bodies and immunoreactivity for vimentin, S-100 protein and epithelial membrane antigen. INTERPRETATION: To the authors' knowledge this is the first report of intradural tumours of the spinal accessory nerves not derived from Schwann cells and the first report of bilateral intracranial meningiomatous lesions without dural attachment.

Accessory Nerve Diseases↗
PubMed2005

Meningioma of the accessory nerve extending from the jugular foramen into the parapharyngeal space.

A 35-year-old man presented with pain in the right shoulder and neck for 18 months. The neurological examination revealed complete accessory nerve palsy on the right side without further deficits. Magnetic resonance imaging showed a right parapharyngeal tumour expanding into the posterior fossa through the jugular foramen without dural attachment and absence of invasion into the middle ear cavity or internal auditory meatus. Intraoperative inspection disclosed a tumour originating from the accessory nerve. Histological diagnosis revealed a meningothelial meningioma with invasion of the epineural space. To the knowledge of the authors this is the first report of an accessory nerve meningioma in the jugular foramen associated with a posterior fossa component and extension into the parapharyngeal space.

Accessory Nerve Diseases↗
PubMed2000

Nerve lesions about the shoulder.

The shoulder is the most mobile joint in the body. Because it serves as a way station for the nerves supplying the upper limb, it creates a potential for nerve lesions that may be caused or significantly influenced by the complex dynamics of the shoulder girdle. This article presents the most commonly encountered lesions as well as an algorithm for their diagnosis and treatment.

Accessory Nerve Diseases↗
PubMed2004

[Acute, isolated and reversible paralysis of the soft palate in childhood].

INTRODUCTION: Unilateral spinal and accessory palsy is uncommon in children. The main problem is the extensive exploration undertaken to achieve etiological diagnosis. OBSERVATION: We report two cases of transitory, unilateral, spinal and accessory palsy, associated in one case with homolateral hemi-pharyngeal palsy, that occurred in two previously healthy children. RESULTS: Few reports have been published in the literature to date. From those two cases and data of the literature, we suggest that the clinical presentation results from idiopathic peripheral nerve palsy. CONCLUSION: Further case reports would be useful to confirm the benign nature of this syndrome so that complementary investigations may be limited in future cases with a similar presentation.

Accessory Nerve Diseases↗
PubMed1999

Malignant peripheral nerve sheath tumour of the spinal accessory nerve.

A 50-year-old man presented with a left-sided neck mass. Clinical examination revealed a large fluctuant 7 cm x 7 cm mass in the left posterior triangle. Magnetic resonance imaging (MRI) revealed an encapsulated soft tissue lesion. He underwent exploration of the neck and a 14 cm by 8 cm mass enfolding the accessory nerve was identified and completely excised. Histological examination of the surgical specimen showed features in keeping with a malignant peripheral nerve sheath tumour (MPNST). We present the clinical and pathological features of this condition.

Accessory Nerve Diseases↗