Symptoma

Accessory Nerve Palsy

Eleventh Cranial Nerve Disorder

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

  • Weakness

    We report a case of a 52-yr-old male patient who presented with right shoulder weakness, drooping of shoulder, and weakness of forward elevation after CABG. [ncbi.nlm.nih.gov]

  • Surgical Procedure

    There was no related trauma, nor any past history of surgical procedures. An electromyographic study confirmed the idiopathic paralysis of the distal segment of the spinal accessory nerve. [ncbi.nlm.nih.gov]

  • Arm Pain

    Three months after the injury, he was complaining about left arm pain in abduction to shoulder level and a decreased range of movement. [ncbi.nlm.nih.gov]

    Pain may worsen when the weight of the involved shoulder is not supported, placing strain upon the shoulder joint. [emedicine.medscape.com]

  • Asymptomatic

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

  • Pleural Effusion

    Risks and 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 [mistysurimd.com]

  • Shoulder Pain

    Abstract After apparently uncomplicated excision of benign lesions in the posterior cervical triangle, two patients had shoulder pain. In one, neck pain and trapezius weakness were not prominent until one month after surgery. [ncbi.nlm.nih.gov]

  • Neck Pain

    In one, neck pain and trapezius weakness were not prominent until one month after surgery. [ncbi.nlm.nih.gov]

    Neck pain is a very common symptom; it results from injury to structures of the cervical spine, including the disc annulus, facet joint capsules, muscles, dorsal root ganglia and nerve roots. [cmaj.ca]

    Regards, Noirin, Dublin 2013. posted 3/2019 Some members have reported some help with neck pain by the use of Theraworx topical spray. I found it at my local pharmacy. [webwhispers.org]

    Whiplash injury: In whiplash injuries, symptoms are limited to the neck and include neck pain, headache, cervical spine rigidity, and limitation of neck motion. [18] Indications The indications for spinal accessory nerve repair are as follows: Iatrogenic [emedicine.medscape.com]

  • Weakness of the Trapezius Muscle

    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]

    A spinal accessory nerve injury can be caused by trauma or damage during surgery, resulting in shoulder pain, "winging" of the shoulder blades and weakness of the trapezius muscle. [hopkinsmedicine.org]

    Interruption of the nerve supply to the sternocleidomastoid muscle results in an asymmetric neckline, while weakness of the trapezius muscle can produce a drooping shoulder, winged scapula, and a weakness of forward elevation of the shoulder. [1] Causes [en.wikipedia.org]

    […] of the trapezius muscle and sternocleidomastoid ( CN XI ) Cavernous sinus syndrome CN III, IV, V 1 ,V 2, VI Neoplasm or inflammation affecting the cavernous sinus (e.g., Tolosa-Hunt syndrome) Intracavernous aneurysms Cavernous sinus thrombosis Impaired [amboss.com]

  • Left Shoulder Pain

    A 38- year-old male with left shoulder pain, scapular deviation and weakness in the left upper extremity, whose symptoms developed over a two-year period following a traffic accident, is presented herein. [ncbi.nlm.nih.gov]

    Critical Essential Core Tested Community Questions (13) (SAE07SM.9) A 50-year-old man reports left shoulder pain and weakness after undergoing a lymph node biopsy in his neck 2 years ago. Examination reveals winging of the left scapula. [orthobullets.com]

  • Mononeuropathy

    Available from: Sir, Spinal accessory nerve (SAN) palsy is an uncommon pure motor mononeuropathy. Fibers of the spinal branch of the SAN innervate the sternocleidomastoid and trapezius muscles. [1] We present a case with SAN palsy. [neurologyindia.com]

    Spinal accessory mononeuropathy following posterior fossa decompression surgery. Acta Neurol Scand 105:326–329 PubMed CrossRef Google Scholar 11. Sweeney PJ, Wilbourn AJ (1992) Spinal accessory (11th) nerve palsy following carotid endarterectomy. [link.springer.com]

    A cranial nerve mononeuropathy is a condition in which only a single cranial nerve or nerve group is damaged. [amboss.com]

    Brachial plexopathies and proximal mononeuropathies. In: Dumitru D, Amato AA, Zwarts MJ, eds. Electrodiagnostic Medicine. 2nd ed. Philadelphia, PA: Hanley & Belfus; 2002:800-813. 4. Boykin RE, Friedman DJ, Higgins LD, Warner JJ. [now.aapmr.org]

    […] accessory G52.8 Compression cranial nerve G52.9 ICD-10-CM Diagnosis Code G52.9 Cranial nerve disorder, unspecified 2016 2017 2018 2019 Billable/Specific Code eleventh G52.8 Disorder (of) - see also Disease nerve G58.9 ICD-10-CM Diagnosis Code G58.9 Mononeuropathy [icd10data.com]

  • Cranial Nerve Involvement

    The extent of cranial nerve involvement may include the cisternal, foraminal, and extracranial (Spinal or intra Sternocleidomastoid) segments of the spinal accessory nerve (Which the extracranial form is the least common ones been reported).( 7, 8 ) [ispub.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]

  • Pleural Effusion

    Risks and 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 [mistysurimd.com]

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]

Accessory Nerve Injury Treatment and Management. Medscape. 2016. Found at: [oncolink.org]

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]

[…] partial forms that are well-tolerated. [1] Although MRI reveals muscle abnormalities in more than 50% of cases, the most helpful diagnostic tests in confirming SAN palsy are nerve conduction studies and electromyography. [3] The role of EMG in predicting prognosis [neurologyindia.com]

Carenfelt C, Eliasson K (1980) Occurrence, duration and prognosis of unexpected accessory nerve paresis in radical neck dissection. Acta Otolaryngol 90:470–473 PubMed Google Scholar 8. Vastamaki M, Solonen KA (1984) Accessory nerve injury. [link.springer.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]

A simple clinical and etiologic classification of the winged scapula is proposed based on the study of these patients in conjunction with a review of the literature. Winging of the scapula is either static or dynamic. [scienceopen.com]

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]

[…] 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]

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]

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]