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Idiopathic spinal accessory nerve palsy. A case report.

N N Sergides¹, D D Nikolopoulos, I G Polyzois

¹Orthopaedic Department, Central Clinic of Athens, Diagnostic and Treatment Center, Asklepiou 31 STR, ZC 10680, Athens, Greece.

Orthopaedics & Traumatology, Surgery & Research : OTSR

|June 29, 2010

Summary

Idiopathic spinal accessory nerve palsy, causing trapezius muscle paralysis, is extremely rare. This case highlights an isolated instance in a 42-year-old male without trauma or surgery, confirmed by electromyography.

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Area of Science:

Neurology
Neurosurgery
Electromyography

Background:

Spinal accessory nerve palsy often results from iatrogenic causes, trauma, infection, or tumors, leading to trapezius muscle dysfunction.
Idiopathic cases, without a clear underlying cause, are exceptionally uncommon in medical literature.

Observation:

A 42-year-old Caucasian male presented with isolated, unilateral paralysis of his ipsilateral trapezius muscle.
The patient had no history of trauma, surgery, infection, or tumor that could explain the nerve palsy.

Findings:

Electromyographic (EMG) studies confirmed the diagnosis of idiopathic paralysis.
The paralysis specifically affected the distal segment of the spinal accessory nerve, impacting the trapezius muscle.

Implications:

This case expands the understanding of idiopathic spinal accessory nerve palsy, suggesting it may occur without identifiable triggers.
Highlights the importance of electromyography in diagnosing rare neurological conditions affecting cranial nerves.
Contributes to the differential diagnosis of isolated trapezius muscle weakness.