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Bilateral neurogenic thoracic outlet syndrome
Hacer Erdem Tilki1, Erik Stålberg, Lütfi Incesu
1Department of Neurology, Ondokuz Mayis University, Samsun, Turkey. hacererdem@superonline.com
Muscle & Nerve
|December 25, 2003
Summary
Bilateral neurogenic thoracic outlet syndrome (TOS) can occur, even with bilateral cervical ribs. This condition should be considered in young women with strenuous upper limb occupations presenting with bilateral symptoms.
Area of Science:
- Neurology
- Orthopedics
- Anatomy
Background:
- Thoracic outlet syndrome (TOS) is a condition caused by compression of nerves or blood vessels in the thoracic outlet.
- Neurogenic TOS, the most common form, involves compression of the brachial plexus nerves.
- While often unilateral, bilateral presentations are possible.
Observation:
- A case of bilateral neurogenic TOS is presented.
- Electrophysiological studies indicated bilateral lower brachial plexus neuropathy.
- Radiography revealed rudimentary bilateral cervical ribs.
Findings:
- The patient presented with bilateral symptoms, contrary to most reported cases which are unilateral despite bilateral bony abnormalities.
- This case highlights that bilateral neurogenic TOS can manifest clinically.
Implications:
- Neurogenic TOS should be suspected in young women with physically demanding jobs involving the upper limbs, especially if bilateral symptoms are present.
- The findings suggest a need to consider bilateral TOS in differential diagnoses, even with atypical presentations.