We describe the previously unreported occurrence of a glomus tumour presenting with a unilateral accessory nerve palsy. [ncbi.nlm.nih.gov]

Specifically, this presentation discusses the topic of treatment for brachial plexus injuries, which includes presentation of common injury patterns, ma... [passioeducation.com]

• Falling

  Clinically, paralysis of the trapezius muscle leads to weakness, downward rotation of the scapulae and falling down of the shoulder girdle. [ncbi.nlm.nih.gov]

  Where there is bilateral paralysis of the sterno-mastoid with atrophy, the head falls backward, but if the trapezii are affected the head falls forward. Treatment . [henriettes-herb.com]

  Wolfe had fixed the arm of a man who had a tree fall on him. Another story talked about how he performed surgery on the hands of the concert pianist, Misha Dichter. Said Anne, “I thought, this is my guy and called his office.” [hss.edu]

  4618 3 Upper and lower subscapular nerves ML 2 Select Answer to see Preferred Response PREFERRED RESPONSE 5 Sorry, this question is for PEAK Premium Subscribers only (OBQ12.114) A 72-year-old male presents with left shoulder and scapular pain after a fall [orthobullets.com]

  Bilateral trapezius paresis results in weakness of neck extension, with the head tending to fall forward when the patient attempts to stand erect. [neupsykey.com]

• Fatigue

  Clonic spasms are apt to be more painful than tonic spasms, the latter exhibiting more fatigue of the muscles than actual pain. Prognosis . [henriettes-herb.com]

  However, most patients have early fatigue in the involved side if asked to perform repetitive activities. [musculoskeletalkey.com]

  The typical symptom is arm fatigue with overhead activity or throwing. There may be associated paresthesias of the lateral and posterior upper arm. Examination reveals weak lateral abduction and external rotation of the arm. [aafp.org]

• Asymptomatic

  Winging of the scapula is a surprisingly common physical sign, but because it is often asymptomatic it receives little attention. [scienceopen.com]

• Hypotension

  Because the receptor works as a mechanical transducer, any kind of distortion of the carotid sinus can cause slowing of the pulse and hypotension. [dartmouth.edu]

• Hypertension

  Olfactory nerve palsy Optic nerve palsy Oculomotor nerve lesion (III) Isolated oculomotor nerve palsy Etiology Ischemic microangiopathy (more common in patients above the age of 60 ) Diabetic cranial mononeuropathy Hypertension Compression or transection [amboss.com]

• Fracture

  The thoroughly revised fractures section includes new information on two-, three-, and four-part fractures and AC/SC fractures. This edition contains over 800 illustrations. [books.google.com]

  In addition, it may be caused by fractures in the jugular foramina, traumas or skull base tumors. Clinically, paralysis of the trapezius muscle leads to weakness, downward rotation of the scapulae and falling down of the shoulder girdle. [ncbi.nlm.nih.gov]

  […] tenderness or deformity Ruptured distal biceps muscle or tendon Cubital fossa tenderness or swelling Joint capsule strain or hyperextension injury; look for median and musculocutaneous nerve injury Epicondyles or distal humerus Fracture Radial head Fracture [aafp.org]

  Assess fall risk and home hazards in older adults to reduce risk of shoulder girdle fracture/dislocation. [now.aapmr.org]

  […] complications Although scapulothoracic fusion is a safe procedure, various risks and complications have been reported that include: Metalwork failure Adhesive capsulitis Nonunion of bone Pneumothorax Pleural effusion Thoracic outlet syndrome Pneumonia Scapula fracture [mistysurimd.com]

• Winged Scapula

  Record : found Abstract : found Article : not found The winged scapula. Twenty-five patients with 23 different types of winging of the scapula are described. [scienceopen.com]

  A winged scapula due to spinal accessory nerve damage will often be exaggerated on arm abduction. Strength testing is similar to range of motion testing, except that the patient performs the actions against the examiner's resistance. [en.wikipedia.org]

  One think I do have on my side is that I went back to him and showed him my wingged scapula, frozen shoulder, etc. He did NOT send me for further testing at his expense which is clear Negligence. Do you live in Ca? Thanks again! [neurotalk.org]

  Hi Guys, About 4 months ago I woke up with extreme pain in my traps, I cant raise my arm lateraly, winged scapula, and my traps/SCM dont fully contract. [forum.bodybuilding.com]

  The winged scapula. Clin Orthop Relat Res 1984;185:228-236. [clinicalgate.com]

• Dystonia

  A physical examination revealed bilateral sternocleidomastoid wasting together with trapezius spasm (dystonia) and hypertrophy ( Fig. 1 ). [cmaj.ca]

  Spasmodic torticollis (ST), also known as cervical dystonia, is characterized by involuntary movements of the head as a result of muscle spasms in the neck and shoulders. [umanitoba.ca]

• Tremor

  Protrusion frequently causes a fine tremor in the normal tongue, which can obscure or mimic fasciculations. Simply having the patient protrude their tongue in the midline tests strength of the tongue. [dartmouth.edu]

  These symptoms could include mental illness (hallucinations and the like), trouble speaking, hearing, seeing, the inability to properly move the body, tremors, and more. [militarydisabilitymadeeasy.com]

• Cranial Nerve Involvement

  Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are the most rare. [ispub.com]

• Myelopathy

  […] it is located in the cervical area. spinal accessory nerve see accessory nerve, Table 14. congenital spinal stenosis stenosis of the vertebral canal present at birth; recorded in calves. spinal fibrocartilaginous emboli see fibrocartilaginous embolic myelopathy [medical-dictionary.thefreedictionary.com]

• Trigeminal Neuralgia

  Involvement of any of the three branches can cause trigeminal neuralgia. [amboss.com]

[…] muscle—greater auricular nerve (GAN) flap, with the advantage of having an interpositioned graft vascularized by fascia and muscle with no donor site morbidity. [10] Diagnostic methods and nerve-salvaging strategies are discussed in further detail in the Workup [emedicine.medscape.com]

If new symptoms or significant worsening of existing symptoms occurs, neuroimaging, electrodiagnostics, or surgical referral should be considered. 8 Patients who have multiple occurrences of stingers should also have a more thorough workup, because they [aafp.org]

Accessory Nerve Injury Treatment and Management. Medscape. 2016. Found at: http://emedicine.medscape.com/article/1298684-treatment#d9 [oncolink.org]

Abstract Four patients were referred to the Royal National Orthopaedic Hospital with iatrogenic accessory nerve palsy because their symptoms were severe enough to warrant surgical treatment. [ncbi.nlm.nih.gov]

Treatment The treatment of spinal accessory nerve palsy includes physical therapy as the main conservative or non-surgical component. For patients not responding to the conservative methods, surgery is considered for them. [mistysurimd.com]

Overiew of Treatments The goal of treatment is to reduce the symptoms of spasmodic torticollis (ST), while minimizing the risks of the interventions. There is little consensus about the best management strategy. [umanitoba.ca]

The prognosis was better following blunt trauma, stretch injuries and after a spontaneous onset. The anatomical relationships of the accessory nerve and aspects of the clinical picture and management are discussed. [ncbi.nlm.nih.gov]

Prognosis for surgical treatment is most favorable when done within 6 months of injury. 4. [now.aapmr.org]

EMG testing can help guide prognosis, direct conservative and surgical treatment, and reduce patient morbidity. [content.iospress.com]

Various rare etiological factors were also described. Whatever the etiology, the typical clinical features of SAN palsy can be listed as atrophy/weakness of the trapezius muscle and moderate winging of the scapula. [ncbi.nlm.nih.gov]

Etiology Clinical features Extorsion of the eye : inability to depress and adduct the eyeball simultaneously (the pupil shoots upward during attempted adduction of the eyeball) Diplopia ( double vision ) Mild esotropia Trigeminal nerve lesion (V) Etiology [amboss.com]

[…] unspecified nerve at shoulder and upper arm level, left arm, initial encounter A- initial encounter D- subsequent encounter S- sequela Scapular Winging ICD-9 907.4 (Late effect of injury to peripheral nerve of shoulder girdle and upper limb) Scapular Winging Etiology [eorif.com]

[…] shoulder and upper arm level, left arm, initial encounter A- initial encounter D- subsequent encounter S- sequela Scapular Winging ICD-9 907.4 (Late effect of injury to peripheral nerve of shoulder girdle and upper limb) Scapular Winging Etiology / Epidemiology [eorif.com]

Compression Fracture callus Coracobrachialis muscle 5 Backpack palsy Stretch injury Multifocal motor neuropathy Upper/lower subscapular nerves Authors are not aware of any reported cases of mononeuropathy Evaluate for spinal nerve/brachial plexus lesion Epidemiology [now.aapmr.org]

Epidemiology Frequency Iatrogenic SAN injury most commonly occurs following diagnostic lymph node biopsies of the posterior triangle of the neck. Injury rates from these procedures are reportedly 3-8%. [emedicine.medscape.com]

Includes separate chapters focusing on individual neurologic disorders with detailed descriptions from pathophysiology to in-depth analysis. [books.google.com]

[…] neuritis Syringomyelia A study by Kassem et al suggested that idiopathic brachial plexitis can affect the spinal accessory nerve and may be sparked by surgical procedures. [21] Miscellaneous Spontaneous isolated nerve injury has also been reported. [22] Pathophysiology [emedicine.medscape.com]

[…] deltoid Sensory: C5 and C6 dermatomes No protective coverings (epineurium and perineurium) on the nerves after they exit the foramina Increased risk of stretch injury at neck and shoulder regions Contusion or compression of upper trunk at Erb point Pathophysiology [aafp.org]

Builds a knowledge base of required skills for the necessary close observation and monitoring of the neuroscience patient to prevent complications and achieve the best outcomes. [books.google.com]

Physicians at the East-Carolina Brody School of Medicine are currently analyzing these cases in cooperation with the regional Center for Disease Control and Prevention. Hopefully the results will be available soon. [practicalneurology.com]

Patient & family education Counsel patient/family regarding expected course of improvement depending on type of lesion (eg neurapraxic vs axonal) and importance of physical therapy to prevent contracture and improve function. [now.aapmr.org]

Bilateral weakness may prevent the patient from lifting their head off a pillow and the head may be inclined posteriorly for lack of flexor tone. Bilateral weakness suggests muscle or neuromuscular disease. [dartmouth.edu]

The neurotoxin consists of molecules that bind to nerve endings and prevent the release of stimulating neurotransmitters. This means the nerve signal is blocked from reaching the muscle, and hence the muscles no longer contract. [umanitoba.ca]