A Case of Neuralgic Amyotrophy with Vagus and Spinal Accessory Nerve Involvement

J Korean Assoc EMG Electrodiagn Med 2004;6(2):188-192.
Published online May 10, 2004.

Abstract

Neuralgic amyotrophy is a clinical disorder characterized by the acute onset of shoulder and arm pain, followed by weakness and often wasting of involved muscles. The most common pattern of neuralgic amyotrophy appears to be either a single or multiple mononeuropathy primarily affecting the suprascapular, long thoracic, or axillary nerves. Rarely, multiple cranial nerves (IX, X, XI, and XII) can be involved. We experienced a 30-year-old male patient presented with paralysis of upper trapezius and sternocleidomastoid muscles as well as hoarseness which had appreared after anal surgery under spinal anesthesia. The patient has had vocal cord paralysis on the laryngoscopy and electrodiagnostic studies showed spinal accessory neuropathy at the proximal segment. Neuroradiological investigations including cervical MRI, skull base CT, and brain MRI with MR angiography showed no causative pathology.

Key Words: Neuralgic amyotrophy, Vagus nerve, Spinal accessory nerve