Traumatic musculocutaneous neuropathy: a case report

Area of Science:

• Neurology
• Orthopedic Surgery

Background:

• Isolated musculocutaneous nerve injury is rare, usually presenting with motor deficits (biceps/brachialis weakness) and minimal pain.
• Typical onset is post-strenuous exercise, diagnosable via electrophysiological studies.

Observation:

• This case details a musculocutaneous nerve injury after a vigorous push, exhibiting atypical severe, episodic pain radiating from the axilla.
• The patient experienced pain along the musculocutaneous and lateral antebrachial cutaneous nerve distributions.

Findings:

• Conservative treatment, including corticosteroid injections, failed over three months.
• Surgical release via epineurotomy resulted in immediate and complete pain relief.

Implications:

• This case highlights unusual pain symptoms in acute musculocutaneous nerve injury, challenging typical presentations.
• Surgical epineurotomy may be an effective treatment for refractory cases presenting with severe pain, offering an alternative to conservative management.